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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09056AF United Health Centers of The San Joaquin Valley
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Covered Entity Details
Entity Name
United Health Centers of The San Joaquin Valley
Subdivision Name
United Health Centers - Kingsburg
Type
HRSA-Funded Health Center
340B ID
CH09056AF
Entity Address
1251 Draper St
Kingsburg, CA 93631-1934
Grant Number
H80CS00137
Participating Start Date
8/15/2022
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09983
929 SIERRA ST
KINGSBURG, CA 93631
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Navjot Singh, Contracting & Managed Care Officer
(559) 646-6618 Ext: 0039
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2024
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