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CH09604E COMMUNITY CLINIC OF MAUI, INC. (Active)
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Main Details
Name
COMMUNITY CLINIC OF MAUI, INC.
Subdivision Name
Kihei Elementary School
Type
HRSA-Funded Health Center
Site ID
BPS-H80-038203
340B ID
CH09604E
Grant Number
H80CS00722
Additional Details
Current Program Status
Active
Registration Date
7/10/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/15/2024
Last Recertification Date
2/25/2025
Contacts
Authorizing Official
Community Clinic of Maui, Inc.
John Vaz, Chief Executive Officer
(808) 872-1052
Primary Contact
Community Clinic of Maui, Inc
Monique van der Aa, Chief Financial Officer
(808) 872-4017
Addresses
Street Address
250 E Lipoa Street D102
Kihei, HI 96753-8125
Billing Address
COMMUNITY CLINIC OF MAUI, INC.
1881 Nani Street
Wailuku, HI 96793-1811
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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