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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH092420 OLE HEALTH
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Covered Entity Details
Entity Name
OLE HEALTH
Subdivision Name
OLE Health - North Napa Campus
Type
HRSA-Funded Health Center
340B ID
CH092420
Entity Address
1141 PEAR TREE LANE
Suite 100
NAPA, CA 94558-6485
Grant Number
H80CS04219
Participating Start Date
10/1/2004
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09371
300 TRAVIS BLVD
FAIRFIELD, CA 94533
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin E. Moses, Legal Officer
(707) 254-1774 Ext: 8222
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/12/2018
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