340B Drug Pricing Program Database

Name

COMMUNITY CLINIC OF MAUI, INC.

Subdivision Name

Community Clinic of Maui KHAO Satellite Clinic

Type

HRSA-Funded Health Center

Site ID

BPS-H80-005024

340B ID

CH09604A

Grant Number

H80CS00722

Current Program Status

Active

Registration Date

4/1/2004

Participating Start Date

4/1/2004

Participating Approval Date

3/8/2004

Last Recertification Date

2/25/2025

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

Street Address

670A WAIALE ROAD
WAILUKU, HI 96793-2339

Billing Address
Same as Street Address