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DSH120006B CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE (Active)
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Main Details
Name
CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE
Subdivision Name
CASTLE MEDICAL CENTER - Laie RHC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH120006B
Medicare Provider Number
120006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/15/2019
Participating Start Date
10/1/2019
Participating Approval Date
7/25/2019
Last Recertification Date
8/14/2024
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
55-510 KAMEHAMEHA HWY
STE 5
LAIE, HI 96762-1119
Billing Address
Adventist Health castle
640 Ulukahiki Street
Kailua, HI 96734
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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