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LONGS DRUG STORES CALIFORNIA, L.L.C.
FQHC638012D NORTHERN VALLEY INDIAN HEALTH
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Covered Entity Details
Entity Name
NORTHERN VALLEY INDIAN HEALTH
Subdivision Name
Children's Health Center
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638012D
Entity Address
1515 Springfield Dr
175
Chico, CA 95928
Grant Number
Participating Start Date
10/1/2012
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09188
869 NEWVILLE RD
ORLAND, CA 95963
Pharmacy Comments
Contract Details
Approval Date
1/13/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Inder Wadhwa, CEO
(530) 896-9409
Contract Pharmacy Representative
Caremark L.L.C.
Christian reid, 340b Program Director
(401) 770-2118
Signed By Date
1/13/2025
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