Contract Pharmacy Details

LONGS DRUG STORES CALIFORNIA, L.L.C.
CH09365C CLINICAS DEL CAMINO REAL, INC.

Covered Entity Details

Entity Name

CLINICAS DEL CAMINO REAL, INC.

Subdivision Name

Ojai Valley Community Health Center

Type

HRSA-Funded Health Center

340B ID

CH09365C

Entity Address

1200 Maricopa Highway
Ojai, CA 93023-1410

Grant Number

H80CS00550

Participating Start Date

7/1/1995

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

LONGS DRUG STORES CALIFORNIA, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 09530
155 W LOS ANGELES AVE
MOORPARK, CA 93021

Pharmacy Comments

Contract Details

Approval Date

10/15/2015

Contract Begin Date

1/1/2016

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Gagan Pawar, Chief Medical Officer
(805) 659-1740

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

10/15/2015

340B Drug Pricing Program Database