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LONGS DRUG STORES CALIFORNIA, L.L.C.
FQHC638024H United Indian Health Services
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Covered Entity Details
Entity Name
United Indian Health Services
Subdivision Name
Eureka Dental Clinic
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638024H
Entity Address
525 7th Street
Eureka, CA 95501
Grant Number
Participating Start Date
7/1/2024
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09681
1105 MYRTLE AVE
EUREKA, CA 95501
Pharmacy Comments
Contract Details
Approval Date
1/14/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christopher Myers, Chief Clinical Officer
(707) 825-4070
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/14/2025
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