340B Drug Pricing Program Database


HM96826 Kapiolani Medical Center for Women and Children (Active) - information as of 4/27/2025 12:51:05 AM

Main Details
Kapiolani Medical Center for Women and Children
Hemophilia and Thrombosis Treatment Center of Hawaii
Comprehensive Hemophilia Treatment Center
HM96826
H30MC24045


Additional Details
Active
8/21/2012
10/1/2012
8/31/2012
2/10/2025

Contacts

Kapiolani Medical Center for Women and Children
Gidget Ruscetta, Chief Operating Officer
(808) 983-6240

Hawaii Pacific Health
Johnelle Kane, Pharmacy Data Analyst
(808) 983-6239

Addresses

1319 Punahou Street
Honolulu, HI 96826

Kapiolani Medical Center for Women and Children
55 Merchant Street 24th Floor
Honolulu, HI 96813


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

No
Shipping Addresses

Same as Street Address
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884901/13/202004/01/2020  04/01/2020
Contract DetailACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750201/13/202004/01/2020  04/01/2020
Contract DetailACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201001/13/202004/01/2020  04/01/2020
Contract DetailACCREDO HEALTH GROUP, INC.677 ALA MOANA BLVD STE 404
HONOLULUHI96813-541210/15/201901/01/2020  01/01/2020
Contract DetailACCREDO HEALTH GROUP, INC.11411 STRANG LINE RD STE A
LENEXAKS6621501/13/202004/01/2020  04/01/2020
Contract DetailACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349201/13/202004/01/2020  04/01/2020
Contract DetailHAWAII PACIFIC HEALTH SPECIALTY PHARMACY3375 KOAPAKA STREET STE H400
HONOLULUHI9681907/10/202310/01/2023  10/01/2023
Contract DetailPHARMACARE3375 KOAPAKA ST STE G320
HONOLULUHI96819-189804/12/201307/01/2013  02/04/2019
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification1/31/2024 12:14:10 PM2/10/2025 11:00:03 AM2/10/2025 11:00 AM
DetailsLast Recertification DateUpdateRecertification2/2/2023 12:36:34 PM1/31/2024 12:14:10 PM1/31/2024 12:14 PM
ContactsPrimary ContactUpdateChange RequestTsuha-Scarlett, Dawn Director, 340B Program and Pharmacy Regulatory Compliance Hawaii Pacific Health 8084048382Kane, Johnelle Pharmacy Data Analyst Hawaii Pacific Health 808983623912/13/2023 4:41 PM
DetailsLast Recertification DateUpdateRecertification2/16/2022 6:00:18 PM2/2/2023 12:36:34 PM2/2/2023 12:36 PM
ContactsPrimary ContactUpdateProfile Change RequestTsuha-Scarlett, Dawn Director, 340B Program and Pharmacy Regulatory Compliance Hawaii Pacific Health 8085226906Tsuha-Scarlett, Dawn Director, 340B Program and Pharmacy Regulatory Compliance Hawaii Pacific Health 808404838210/14/2022 12:40 PM
DetailsLast Recertification DateUpdateRecertification2/9/2021 6:38:02 PM2/16/2022 6:00:18 PM2/16/2022 6:00 PM
ContactsAuthorizing OfficialUpdateChange RequestSMITH, MARTHA Executive Vice President, Oahu Operations Hawaii Pacific Health 8085222520Ruscetta, Gidget Chief Operating Officer Kapiolani Medical Center for Women and Children 80898362405/6/2021 4:09 PM
DetailsLast Recertification DateUpdateRecertification1/30/2020 12:34:04 PM2/9/2021 6:38:02 PM2/9/2021 6:38 PM
ContactsPrimary ContactUpdateChange RequestTsuha-Scarlett, Dawn Director, Pharmacy Hawaii Pacific Health 8085226906Tsuha-Scarlett, Dawn Director, 340B Program and Pharmacy Regulatory Compliance Hawaii Pacific Health 808522690610/14/2020 2:41 PM
DetailsLast Recertification DateUpdateRecertification2/4/2019 11:43:26 AM1/30/2020 12:34:04 PM1/30/2020 12:34 PM
ContactsAuthorizing OfficialUpdateProfile Change RequestSMITH, MARTHA CEO Kapiolani Medical Center for Women and Children 8089838071SMITH, MARTHA Executive Vice President, Oahu Operations Hawaii Pacific Health 80852225201/30/2020 12:32 PM
ContactsSigned ByUpdateProfile Change RequestSMITH, MARTHA CEO Kapiolani Medical Center for Women and Children 8089838071SMITH, MARTHA Executive Vice President, Oahu Operations Hawaii Pacific Health 80852225201/30/2020 12:32 PM
ContactsPrimary ContactUpdateChange RequestBonilla, Laura Executive Director of Pediatrics Kapiolani Medical Center for Women& Children 8089836169Tsuha-Scarlett, Dawn Director, Pharmacy Hawaii Pacific Health 808522690612/23/2019 12:09 PM
DetailsLast Recertification DateUpdateRecertification2/9/2018 12:15:04 PM2/4/2019 11:43:26 AM2/4/2019 11:43 AM
AddressesBilling AddressInsertChange Request Kapiolani Medical Center for Women and Children 55 Merchant Street 24th Floor Honolulu, HI 9681311/12/2018 12:15 PM
DetailsLast Recertification DateUpdateRecertification2/2/2017 12:00:00 AM2/9/2018 12:15:04 PM2/9/2018 12:15 PM
ContactsPrimary ContactUpdate Bonilla, Laura Executive Director of Pediatrics 8089836169Bonilla, Laura Executive Director of Pediatrics Kapiolani Medical Center for Women& Children 80898361692/5/2018 5:28 PM
ContactsAuthorizing OfficialUpdate SMITH, MARTHA CEO 8089838071SMITH, MARTHA CEO Kapiolani Medical Center for Women and Children 808983807110/26/2017 1:33 PM
ContactsSigned ByUpdate SMITH, MARTHA CEO 8089838071SMITH, MARTHA CEO Kapiolani Medical Center for Women and Children 808983807110/26/2017 1:33 PM
ContactsAuthorizing OfficialInsert  SMITH, MARTHA CEO 80898380716/20/2017 8:52 PM
ContactsSigned ByInsert  SMITH, MARTHA CEO 80898380716/20/2017 8:52 PM
AddressesMain AddressInsert   1319 Punahou Street Honolulu, HI 968262/2/2017 8:53 PM
ContactsPrimary ContactInsert  Bonilla, Laura Executive Director of Pediatrics 80898361692/2/2017 8:53 PM
DetailsLast Recertification DateUpdate 3/2/2016 12:00:00 AM2/2/2017 12:00:00 AM2/2/2017 8:53 PM
DetailsLast Recertification DateUpdate 2/11/2015 12:00:00 AM3/2/2016 12:00:00 AM3/2/2016 9:00 PM
DetailsLast Recertification DateUpdate 2/21/2014 12:00:00 AM2/11/2015 12:00:00 AM2/11/2015 7:18 AM
DetailsLast Recertification DateUpdate 4/1/2013 12:00:00 AM2/21/2014 12:00:00 AM2/21/2014 1:19 PM
DetailsLast Recertification DateUpdate  4/1/2013 12:00:00 AM2/7/2013 12:56 PM
DetailsGrant NumberUpdate 1H30MC24045-01-01H30MC240458/31/2012 2:01 PM
Details340B IDUpdate IS-AP-HM96826HM968268/31/2012 2:01 PM
DetailsMedicare Provider NumberUpdate 123300 8/31/2012 2:01 PM
DatesParticipating Approval DateUpdate  8/31/2012 12:00:00 AM8/31/2012 2:01 PM
DetailsStateUpdate PendingActive8/31/2012 2:01 PM
DatesStart DateUpdate  10/1/2012 12:00:00 AM8/31/2012 2:01 PM
Details340B IDUpdate AP082312IS-AP-HM968268/24/2012 7:24 AM
Details340B IDUpdate ONLINE_REGAP0823128/23/2012 8:09 AM
DetailsLast Recertification DateInsert   8/21/2012 8:26 PM
DetailsGrant NumberInsert  1H30MC24045-01-018/21/2012 8:26 PM
Details340B IDInsert  ONLINE_REG8/21/2012 8:26 PM
DetailsIs Authorizing Official EHB DataInsert   8/21/2012 8:26 PM
DatesLast Date That 340B Drugs PurchasedInsert   8/21/2012 8:26 PM
DetailsMedicare Provider NumberInsert  1233008/21/2012 8:26 PM
DetailsEntity NameInsert  Kapiolani Medical Center for Women and Children8/21/2012 8:26 PM
DetailsProgram CodeInsert  HM8/21/2012 8:26 PM
DetailsEntity SubnameInsert  Hemophilia and Thrombosis Treatment Center of Hawaii8/21/2012 8:26 PM
DatesParticipating Approval DateInsert   8/21/2012 8:26 PM
DetailsStateInsert  Pending8/21/2012 8:26 PM
DatesRegistration DateInsert  8/21/2012 12:00:00 AM8/21/2012 8:26 PM
DatesSigned By DateInsert  8/21/2012 12:00:00 AM8/21/2012 8:26 PM
DatesStart DateInsert   8/21/2012 8:26 PM
TerminationsTermination CommentsInsert   8/21/2012 8:26 PM
TerminationsTermination DateInsert   8/21/2012 8:26 PM
TerminationsTermination Effective DateInsert   8/21/2012 8:26 PM
TerminationsTermination ReasonInsert   8/21/2012 8:26 PM