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CAH121304-00 KAHUKU MEDICAL CENTER (Active)
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Main Details
Name
KAHUKU MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH121304-00
Medicare Provider Number
121304
Additional Details
Current Program Status
Active
Registration Date
10/11/2017
Participating Start Date
1/1/2018
Participating Approval Date
11/1/2017
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Kahuku Medical Center
Steven Nawahine, Chief Executive Officer
(808) 293-6222
Primary Contact
Kahuku Medical Center
Christopher N Tsue, Director of Pharmacy
(808) 380-1425
Addresses
Street Address
56-117 PUALALEA ST.
KAHUKU, HI 96731
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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