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CH09188G BAY CLINIC, INC. (Terminated)
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Main Details
Name
BAY CLINIC, INC.
Subdivision Name
Hilo Family Dental Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010953
340B ID
CH09188G
Grant Number
H80CS00837
Additional Details
Current Program Status
Terminated
Registration Date
7/2/2014
Participating Start Date
10/1/2014
Participating Approval Date
7/21/2014
Last Recertification Date
2/23/2023
Termination Date
Termination Reason
1/1/2024
Other
Contacts
Authorizing Official
Bay Clinic, Inc
Christian Kimo Alameda, Chief Executive Officer
(808) 930-4083
Primary Contact
BayClinicInc
glenn andrew faust, pharmacist
(808) 930-0488
Addresses
Street Address
1257 Kilauea Avenue
Suite 100
HIlo, HI 96720-4247
Billing Address
Bay Clinic, Inc.
450 Kilauea Ave., Ste. 105
Hilo, HI 96720
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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