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DSH120006M CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE (Active)
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Main Details
Name
CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE
Subdivision Name
ADVENTIST HEALTH CASTLE - Ulukahiki Specialty 103
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH120006M
Medicare Provider Number
120006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/8/2024
Participating Start Date
10/1/2024
Participating Approval Date
9/12/2024
Last Recertification Date
Contacts
Authorizing Official
ADVENTIST HEALTH CASTLE
NICK JOHNSON, FINANCE OFFICER
(808) 263-5142
Primary Contact
Adventist Health Castle
Joni Freitas, Pharmacy Director
(808) 263-5192
Addresses
Street Address
642 ULUKAHIKI ST
STE 103
KAILUA, HI 96734-4418
Billing Address
CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE
640 ULUKAHIKI STREET
KAILUA, HI 96734
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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