340B Drug Pricing Program Database


CH09099P WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATED (Active) - information as of 5/29/2025 1:55:29 AM

Main Details
WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATED
Waipahu Family Health Center
HRSA-Funded Health Center
BPS-H80-029453
CH09099P
H80CS00807


Additional Details
Active
10/7/2019
1/1/2020
10/23/2019
2/11/2025

Contacts

Waianae District Comprehensive Health and Hospital Board, Incorporated
RICHARD BETTINI, President & CEO
(808) 697-3300

Waianae District Comprehensive Health & Hospital Board, Incorporated
Andrea Baltazar, 340B Program Specialist
(808) 697-3438

Addresses

94-428 Mokuola St. STE 213
Waipahu, HI 96797-3396

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites 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 DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09259 94-060 FARRINGTON HWY #6
WAIPAHUHI9679707/02/202410/01/2024  10/01/2024
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA LONGS DRUGS #7356 91-919 FT WEAVER RD., SPACE 106
EWA BEACHHI9670607/02/202410/01/2024 09/10/202405/21/2025
Contract DetailLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09813 98 1005 MOANALUA RD
#400
AIEAHI9670110/11/202401/01/2025  01/01/2025
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH090990ActiveBPS-H80-002044WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDWAIANAE COAST COMPREHENSIVE HEALTH CTR86-260 Farrington Hwy WaianaeHI
CH09099AActiveBPS-H80-001879WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDWaipahu Family Health Center94-428 Mokuola St STE 108B WaipahuHI
CH09099BActiveBPS-H80-004284WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDLEEWARD PEDIATRICS87-2070 Farrington Hwy WaianaeHI
CH09099CActiveBPS-H80-000125WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDWAIOLA CLINIC86-120 FARRINGTON HWYSte C305AWAIANAEHI
CH09099DActiveBPS-H80-009450WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDWest O'ahu Community Health599 Farrington Highway BLDG 1 Unit100 KapoleiHI
CH09099EActiveBPS-H80-003927WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDMALAMA RECOVERY SERVICES89-188 Farrington Hwy WaianaeHI
CH09099FActiveBPS-H80-007278WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDMOBILE SERVICE VAN86-260 Farrington Hwy WaianaeHI
CH09099GActiveBPS-H80-013815WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDKamaile Olakino Maika'i Health Center85-180 Ala Akau St WaianaeHI
CH09099HActiveBPS-H80-012257WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDWest O'ahu Community Health599 Farrington Highway BLDG 1 - 208 KapoleiHI
CH09099JActiveBPS-H80-016815WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDWaianae Vision Care86-120 Farrington Hwy Ste C301 WaianaeHI
CH09099KActiveBPS-H80-015763WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDWaianae High School School-based Health Center85-251 FARRINGTON HWY WAIANAEHI
CH09099LActiveBPS-H80-015755WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDWaianae Intermediate School School-based Health Center85-626 FARRINGTON HWY WAIANAEHI
CH09099MActiveBPS-H80-021708WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDEwa - West O`ahu Community Health Center91-1841 Ft. Weaver Rd. Ewa BeachHI
CH09099NActiveBPS-H80-021663WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDNanakuli High & Intermediate School89-980 Nanakuli Avenue WaianaeHI
CH09099PActiveBPS-H80-029453WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDWaipahu Family Health Center94-428 Mokuola St. STE 213 WaipahuHI
CH09099QActiveBPS-H80-031716WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDThe Comp at Tamura Super Market86-032 Farrington Hwy Ste 101 WaianaeHI
CH09099RActiveBPS-H80-032121WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDJames and Abigail Campbell Clinic89-102 Farrington HwyUnit 3000WaianaeHI
CH09099SActiveBPS-H80-036841WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDNanaikapono Elementary School89-153 Mano Ave WaianaeHI
CH09099TActiveBPS-H80-037312WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDMobile Clinic86-260 Farrington Hwy WaianaeHI
CH09099UActiveBPS-H80-036874WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDWaianae Elementary School85-220 McArthur St WaianaeHI
CH09099VApprovedBPS-H80-038878WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDMakaha Health84-225 Ala Naauau St WaianaeHI
CH09099WApprovedBPS-H80-039335WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDMobile Clinic #286-260 Farrington Hwy WaianaeHI
CH09099XApprovedBPS-H80-039731WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATEDDental Mobile Clinic Van #386-260 Farrington Hwy WaianaeHI
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH090990LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 04728 1130 KUALA ST.
PEARL CITYHI9678207/01/2023  
CH090990LONGS DRUG STORES CALIFORNIA, L.L.C.LONGS DRUGS # 17471 4450 KAPOLEI PKWY
KAPOLEIHI9670707/01/2023  
CH090990LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09956 86 120 FARRINGTON HWY
WAIANAEHI9679207/01/2023  
CH090990LONGS DRUG STORES CALIFORNIA, L.L.C.DBA LONGS DRUGS #7356 91-919 FT WEAVER RD., SPACE 106
EWA BEACHHI9670607/01/2023 09/10/2024
CH090990LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09275 850 KAMEHAMEHA HWY STE 107
PEARL CITYHI9678207/01/2023  
CH090990LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09317 590 FARRINGTON HWY
UNIT 300
KAPOLEIHI9670707/01/2023  
CH090990LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09300 925 CALIFORNIA AVE
WAHIAWAHI9678607/01/2023  
CH090990LONGS DRUG STORES CALIFORNIA, L.L.C.DBA CVS/PHARMACY #7107 89-102 FARRINGTON HWY, UNIT 4
WAIANAEHI9679207/01/2023  
CH090990LONGS DRUG STORES CALIFORNIA, L.L.C.LONGS DRUGS # 10988 84-1160 FARRINGTON HWY
WAIANAEHI9679207/01/2023  
CH090990LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09988 91 1401 FORT WEAVER RD
EWA BEACHHI9670607/01/2023  
CH090990LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09259 94-060 FARRINGTON HWY #6
WAIPAHUHI9679707/01/2023  
CH090990LONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09813 98 1005 MOANALUA RD
#400
AIEAHI9670107/01/2023  
CH09099ALONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09259 94-060 FARRINGTON HWY #6
WAIPAHUHI9679710/01/2024  
CH09099HLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09259 94-060 FARRINGTON HWY #6
WAIPAHUHI9679710/01/2024  
CH09099PLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09259 94-060 FARRINGTON HWY #6
WAIPAHUHI9679710/01/2024  
CH09099CLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09956 86 120 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099SLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09956 86 120 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099KLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09956 86 120 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099PLONGS DRUG STORES CALIFORNIA, L.L.C.DBA LONGS DRUGS #7356 91-919 FT WEAVER RD., SPACE 106
EWA BEACHHI9670610/01/2024 09/10/2024
CH09099DLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09317 590 FARRINGTON HWY
UNIT 300
KAPOLEIHI9670710/01/2024  
CH09099NLONGS DRUG STORES CALIFORNIA, L.L.C.DBA CVS/PHARMACY #7107 89-102 FARRINGTON HWY, UNIT 4
WAIANAEHI9679210/01/2024  
CH09099ALONGS DRUG STORES CALIFORNIA, L.L.C.DBA LONGS DRUGS #7356 91-919 FT WEAVER RD., SPACE 106
EWA BEACHHI9670610/01/2024 09/10/2024
CH09099ELONGS DRUG STORES CALIFORNIA, L.L.C.DBA CVS/PHARMACY #7107 89-102 FARRINGTON HWY, UNIT 4
WAIANAEHI9679210/01/2024  
CH09099JLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09956 86 120 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099HLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09317 590 FARRINGTON HWY
UNIT 300
KAPOLEIHI9670710/01/2024  
CH09099QLONGS DRUG STORES CALIFORNIA, L.L.C.LONGS DRUGS # 10988 84-1160 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099ULONGS DRUG STORES CALIFORNIA, L.L.C.LONGS DRUGS # 10988 84-1160 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099RLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09956 86 120 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099TLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09956 86 120 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099GLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09956 86 120 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099RLONGS DRUG STORES CALIFORNIA, L.L.C.DBA CVS/PHARMACY #7107 89-102 FARRINGTON HWY, UNIT 4
WAIANAEHI9679210/01/2024  
CH09099QLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09956 86 120 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099GLONGS DRUG STORES CALIFORNIA, L.L.C.LONGS DRUGS # 10988 84-1160 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099LLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09956 86 120 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099MLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09988 91 1401 FORT WEAVER RD
EWA BEACHHI9670610/01/2024  
CH09099FLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09956 86 120 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099ELONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09956 86 120 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099JLONGS DRUG STORES CALIFORNIA, L.L.C.LONGS DRUGS # 10988 84-1160 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099TLONGS DRUG STORES CALIFORNIA, L.L.C.DBA CVS/PHARMACY #7107 89-102 FARRINGTON HWY, UNIT 4
WAIANAEHI9679210/01/2024  
CH09099ULONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09956 86 120 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099KLONGS DRUG STORES CALIFORNIA, L.L.C.LONGS DRUGS # 10988 84-1160 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099CLONGS DRUG STORES CALIFORNIA, L.L.C.LONGS DRUGS # 10988 84-1160 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099FLONGS DRUG STORES CALIFORNIA, L.L.C.DBA CVS/PHARMACY #7107 89-102 FARRINGTON HWY, UNIT 4
WAIANAEHI9679210/01/2024  
CH09099DLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09259 94-060 FARRINGTON HWY #6
WAIPAHUHI9679710/01/2024  
CH09099NLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09956 86 120 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099SLONGS DRUG STORES CALIFORNIA, L.L.C.DBA CVS/PHARMACY #7107 89-102 FARRINGTON HWY, UNIT 4
WAIANAEHI9679210/01/2024  
CH09099MLONGS DRUG STORES CALIFORNIA, L.L.C.DBA LONGS DRUGS #7356 91-919 FT WEAVER RD., SPACE 106
EWA BEACHHI9670610/01/2024 09/10/2024
CH09099LLONGS DRUG STORES CALIFORNIA, L.L.C.LONGS DRUGS # 10988 84-1160 FARRINGTON HWY
WAIANAEHI9679210/01/2024  
CH09099PLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09813 98 1005 MOANALUA RD
#400
AIEAHI9670101/01/2025  
CH09099ELONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09300 925 CALIFORNIA AVE
WAHIAWAHI9678601/01/2025  
CH09099LLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09988 91 1401 FORT WEAVER RD
EWA BEACHHI9670601/01/2025  
CH09099HLONGS DRUG STORES CALIFORNIA, L.L.C.LONGS DRUGS # 17471 4450 KAPOLEI PKWY
KAPOLEIHI9670701/01/2025  
CH09099GLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 09275 850 KAMEHAMEHA HWY STE 107
PEARL CITYHI9678201/01/2025  
CH09099MLONGS DRUG STORES CALIFORNIA, L.L.C.DBA: LONGS DRUGS # 04728 1130 KUALA ST.
PEARL CITYHI9678201/01/2025  
CH090990VALUE DRUG LTD. DBA PHARMACARE3375 KOAPAKA ST STE G320
HONOLULUHI96819-189801/01/2020  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification2/13/2024 12:08:22 AM2/11/2025 12:56:51 PM2/11/2025 12:56 PM
DetailsLast Recertification DateUpdateRecertification2/2/2023 1:52:19 AM2/13/2024 12:08:22 AM2/13/2024 12:08 AM
DetailsLast Recertification DateUpdateRecertification2/16/2022 2:03:41 AM2/2/2023 1:52:19 AM2/2/2023 1:52 AM
ContactsPrimary ContactUpdatePC Change RequestDasig, Edith Contracting & Credentialing Manager Waianae District Comprehensive Health & Hospital Board, Incorporated 8086973493Baltazar, Andrea 340B Program Specialist Waianae District Comprehensive Health & Hospital Board, Incorporated 80869734386/24/2022 6:23 AM
ContactsAuthorizing OfficialUpdateGroup Change RequestChen, James Z. CFO Waianae District Comprehensive Health and Hospital Board, Incorporated 8086973300BETTINI, RICHARD President & CEO Waianae District Comprehensive Health and Hospital Board, Incorporated 80869733005/17/2022 6:22 AM
DetailsLast Recertification DateUpdateRecertification2/27/2021 11:11:41 PM2/16/2022 2:03:41 AM2/16/2022 2:03 AM
DetailsLast Recertification DateUpdateRecertification1/30/2020 4:54:30 PM2/27/2021 11:11:41 PM2/27/2021 11:11 PM
DetailsLast Recertification DateUpdateRecertification 1/30/2020 4:54:30 PM1/30/2020 4:54 PM
DetailsStateUpdate ApprovedActive1/1/2020 12:04 AM
ContactsSigned ByInsertNew Registration Chen, James Z. CFO Waianae District Comprehensive Health and Hospital Board, Incorporated 808697330010/23/2019 7:11 AM
Details340B IDUpdateNew Registration CH09099P10/23/2019 7:11 AM
DatesParticipating Approval DateUpdateNew Registration 10/23/2019 7:11:34 AM10/23/2019 7:11 AM
DetailsStateUpdateNew RegistrationPendingApproved10/23/2019 7:11 AM
DatesSigned By DateUpdateNew Registration 10/15/2019 10:42:58 PM10/23/2019 7:11 AM
DatesStart DateUpdateNew Registration 1/1/2020 12:00:00 AM10/23/2019 7:11 AM
AddressesMain AddressInsertNew Registration  94-428 Mokuola St. STE 213 Waipahu, HI 96797-339610/7/2019 4:44 PM
ContactsAuthorizing OfficialInsertNew Registration Chen, James Z. CFO Waianae District Comprehensive Health and Hospital Board, Incorporated 808697330010/7/2019 4:44 PM
ContactsPrimary ContactInsertNew Registration Dasig, Edith Contracting & Credentialing Manager Waianae District Comprehensive Health & Hospital Board, Incorporated 808697349310/7/2019 4:44 PM
DetailsLast Recertification DateInsertNew Registration  10/7/2019 4:44 PM
DetailsGrant NumberInsertNew Registration H80CS0080710/7/2019 4:44 PM
Details340B IDInsertNew Registration  10/7/2019 4:44 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  10/7/2019 4:44 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  10/7/2019 4:44 PM
DetailsMedicare Provider NumberInsertNew Registration  10/7/2019 4:44 PM
DetailsEntity NameInsertNew Registration WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATED10/7/2019 4:44 PM
DetailsProgram CodeInsertNew Registration CH10/7/2019 4:44 PM
DetailsEntity SubnameInsertNew Registration Waipahu Family Health Center10/7/2019 4:44 PM
DatesParticipating Approval DateInsertNew Registration  10/7/2019 4:44 PM
DetailsStateInsertNew Registration Pending10/7/2019 4:44 PM
DatesRegistration DateInsertNew Registration 10/7/2019 4:44:54 PM10/7/2019 4:44 PM
DatesSigned By DateInsertNew Registration  10/7/2019 4:44 PM
DatesStart DateInsertNew Registration  10/7/2019 4:44 PM
TerminationsTermination CommentsInsertNew Registration  10/7/2019 4:44 PM
TerminationsTermination DateInsertNew Registration  10/7/2019 4:44 PM
TerminationsTermination Effective DateInsertNew Registration  10/7/2019 4:44 PM
TerminationsTermination ReasonInsertNew Registration  10/7/2019 4:44 PM