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GARFIELD BEACH CVS, L.L.C.
CH090710 COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.
Subdivision Name
NIPOMO COMMUNITY MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH090710
Entity Address
150 TEJAS PL
NIPOMO, CA 93444-9123
Grant Number
H80CS00621
Participating Start Date
4/1/1996
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
CVS PHARMACY # 16488
2305 THEATRE DR
PASO ROBLES, CA 93446
Pharmacy Comments
Contract Details
Approval Date
10/2/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
RONALD E. CASTLE, CEO
(805) 459-1835
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/2/2017
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