Yes
HI | 082268 | 1316937691 |
CA | | 1316937691 |
FL | | 1316937691 |
WA | | 1316937691 |
OR | | 1316937691 |
AK | | 1316937691 |
CO | | 1316937691 |
KY | | 1316937691 |
AS | | 1316937691 |
MO | | 1316937691 |
MT | | 1316937691 |
NY | | 1316937691 |
NV | | 1316937691 |
VA | | 1316937691 |
AL | | 1316937691 |
DSH120006A | Child | DSH | CASTLE MEDICAL CENTER | Castle Medical Center OP Clinic | 642 Ulukahiki Street Suite 103 | Kailua | HI | Terminated |
DSH120006B | Child | DSH | CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE | CASTLE MEDICAL CENTER - Laie RHC | 55-510 KAMEHAMEHA HWY | LAIE | HI | Active |
DSH120006C | Child | DSH | CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE | AHCS ONCOLOGY CLINIC - HEMATOLOGY / ONCOLOGY | 642 ULUKAHIKI STREET, SUITE 300 | KAILUA | HI | Active |
DSH120006D | Child | DSH | CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE | ADVENTIST HEALTH CASTLE - Ulukahiki 300 - Specialty (Surgery) | 642 ULUKAHIKI ST | KAILUA | HI | Active |
DSH120006E | Child | DSH | CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE | ADVENTIST HEALTH CASTLE - Primary Care/Specialty | 40 AULIKE ST | KAILUA | HI | Active |
DSH120006F | Child | DSH | CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE | ADVENTIST HEALTH CASTLE - Kaneohe Specialty - CPC 202 | 46-001 KAMEHAMEHA HWY | KANEOHE | HI | Active |
DSH120006G | Child | DSH | CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE | ADVENTIST HEALTH CASTLE - Ulukahiki OBGYN | 642 ULUKAHIKI ST | KAILUA | HI | Active |
DSH120006H | Child | DSH | CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE | ADVENTIST HEALTH CASTLE - Kaneohe Primary Care 401 | 46-001 KAMEHAMEHA HWY | KANEOHE | HI | Active |
DSH120006J | Child | DSH | CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE | ADVENTIST HEALTH CASTLE - Kaneohe Specialty - CPC 102 | 46-001 KAMEHAMEHA HWY | KANEOHE | HI | Active |
DSH120006K | Child | DSH | CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE | ADVENTIST HEALTH CASTLE - Ulukahiki Specialty 207 (Neurology) | 642 ULUKAHIKI ST | KAILUA | HI | Active |
DSH120006L | Child | DSH | CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE | ADVENTIST HEALTH CASTLE - Aulike Psychiatry 217 | 40 AULIKE ST | KAILUA | HI | Active |
DSH120006M | Child | DSH | CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE | ADVENTIST HEALTH CASTLE - Ulukahiki Specialty 103 | 642 ULUKAHIKI ST | KAILUA | HI | Active |
DSH120006N | Child | DSH | CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE | ADVENTIST HEALTH CASTLE - Aulike Primary Care 300 | 30 AULIKE ST | KAILUA | HI | Active |
DSH120006P | Child | DSH | CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE | ADVENTIST HEALTH CASTLE - CMC Specialty | 321 N KUAKINI ST | HONOLULU | HI | Active |
DSH120006Q | Child | DSH | CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE | CASTLE MEDICAL CENTER - CMC Primary Care | 321 N KUAKINI ST | HONOLULU | HI | Active |
Details | State | Update | | Approved | Active | 10/1/2024 12:01 AM |
Contacts | Signed By | Insert | New Registration | | JOHNSON, NICK
FINANCE OFFICER
ADVENTIST HEALTH CASTLE
8082635142 | 9/12/2024 3:29 PM |
Details | 340B ID | Update | New Registration | | DSH120006E | 9/12/2024 3:29 PM |
Details | Entity Subname | Update | New Registration | ADVENTIST HEALTH CASTLE | ADVENTIST HEALTH CASTLE - Primary Care/Specialty | 9/12/2024 3:29 PM |
Dates | Participating Approval Date | Update | New Registration | | 9/12/2024 3:29:25 PM | 9/12/2024 3:29 PM |
Details | State | Update | New Registration | Pending | Approved | 9/12/2024 3:29 PM |
Dates | Signed By Date | Update | New Registration | | 7/10/2024 8:05:04 PM | 9/12/2024 3:29 PM |
Dates | Start Date | Update | New Registration | | 10/1/2024 12:00:00 AM | 9/12/2024 3:29 PM |
Addresses | Main Address | Insert | New Registration | |
40 AULIKE ST
STE 410
KAILUA, HI 96734-2757 | 7/8/2024 10:27 PM |
Addresses | Billing Address | Insert | New Registration | | CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE
640 ULUKAHIKI STREET
KAILUA, HI 96734 | 7/8/2024 10:27 PM |
Medicaid Billing | Medicaid: Is Primary | Insert | New Registration | | False | 7/8/2024 10:27 PM |
Medicaid Billing | Medicaid: Number | Insert | New Registration | | 082268 | 7/8/2024 10:27 PM |
Medicaid Billing | Medicaid: State | Insert | New Registration | | HI | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1316937691 | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: State | Insert | New Registration | | HI | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1316937691 | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: State | Insert | New Registration | | CA | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1316937691 | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: State | Insert | New Registration | | FL | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1316937691 | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: State | Insert | New Registration | | WA | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1316937691 | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: State | Insert | New Registration | | OR | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1316937691 | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: State | Insert | New Registration | | AK | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1316937691 | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: State | Insert | New Registration | | CO | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1316937691 | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: State | Insert | New Registration | | KY | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1316937691 | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: State | Insert | New Registration | | AS | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1316937691 | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: State | Insert | New Registration | | MO | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1316937691 | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: State | Insert | New Registration | | MT | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1316937691 | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: State | Insert | New Registration | | NY | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1316937691 | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: State | Insert | New Registration | | NV | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1316937691 | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: State | Insert | New Registration | | VA | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: Number | Insert | New Registration | | 1316937691 | 7/8/2024 10:27 PM |
Medicaid Billing | NPI: State | Insert | New Registration | | AL | 7/8/2024 10:27 PM |
Contacts | Primary Contact | Insert | New Registration | | Freitas, Joni
Pharmacy Director
Adventist Health Castle
8082635192 | 7/8/2024 10:27 PM |
Contacts | Authorizing Official | Insert | New Registration | | JOHNSON, NICK
FINANCE OFFICER
ADVENTIST HEALTH CASTLE
8082635142 | 7/8/2024 10:27 PM |
Details | Assistance Received From Date | Insert | New Registration | | | 7/8/2024 10:27 PM |
Details | Assistance Received To Date | Insert | New Registration | | | 7/8/2024 10:27 PM |
Details | Last Recertification Date | Insert | New Registration | | | 7/8/2024 10:27 PM |
Details | Grant Number | Insert | New Registration | | | 7/8/2024 10:27 PM |
Details | 340B ID | Insert | New Registration | | | 7/8/2024 10:27 PM |
Details | Is Authorizing Official EHB Data | Insert | New Registration | | | 7/8/2024 10:27 PM |
Dates | Last Date That 340B Drugs Purchased | Insert | New Registration | | | 7/8/2024 10:27 PM |
Details | Medicare Provider Number | Insert | New Registration | | 120006 | 7/8/2024 10:27 PM |
Details | Entity Name | Insert | New Registration | | CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE | 7/8/2024 10:27 PM |
Details | NOFO Number | Insert | New Registration | | | 7/8/2024 10:27 PM |
Details | Program Code | Insert | New Registration | | DSH | 7/8/2024 10:27 PM |
Details | Entity Subname | Insert | New Registration | | ADVENTIST HEALTH CASTLE | 7/8/2024 10:27 PM |
Dates | Participating Approval Date | Insert | New Registration | | | 7/8/2024 10:27 PM |
Details | State | Insert | New Registration | | Pending | 7/8/2024 10:27 PM |
Dates | Registration Date | Insert | New Registration | | 7/8/2024 10:27:01 PM | 7/8/2024 10:27 PM |
Dates | Signed By Date | Insert | New Registration | | | 7/8/2024 10:27 PM |
Dates | Start Date | Insert | New Registration | | | 7/8/2024 10:27 PM |
Terminations | Termination Comments | Insert | New Registration | | | 7/8/2024 10:27 PM |
Terminations | Termination Date | Insert | New Registration | | | 7/8/2024 10:27 PM |
Terminations | Termination Effective Date | Insert | New Registration | | | 7/8/2024 10:27 PM |
Terminations | Termination Reason | Insert | New Registration | | | 7/8/2024 10:27 PM |