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LONGS DRUG STORES CALIFORNIA, L.L.C.
STD90013 The Wall Las Memorias
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Covered Entity Details
Entity Name
The Wall Las Memorias
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD90013
Entity Address
333 S. Spring Street
F5
Los Angeles, CA 90013
Grant Number
NU62PS924569
Participating Start Date
10/1/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09985
8900 SEPULVEDA WESTWAY
LOS ANGELES, CA 90045
Pharmacy Comments
Contract Details
Approval Date
4/2/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard Zaldivar, Executive Director
(323) 257-1056 Ext: 27
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/2/2025
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