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DSH120006 CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE (Active)
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Main Details
Name
CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH120006
Medicare Provider Number
120006
Additional Details
Current Program Status
Active
Registration Date
2/16/2006
Participating Start Date
4/1/2006
Participating Approval Date
2/22/2006
Last Recertification Date
8/29/2024
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
640 ULUKAHIKI STREET
KAILUA, HI 96734
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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4/6/12 ADDED SHIP ADD 1 AND SHIP ADD 2
04/06/2012
May 2025
May 2025
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