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DSH120006C CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE (Active)
Main Details
Name
CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE
Subdivision Name
AHCS ONCOLOGY CLINIC - HEMATOLOGY / ONCOLOGY
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH120006C
Medicare Provider Number
120006
Outpatient Facility Provider Number
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
Additional Details
Current Program Status
Active
Registration Date
10/14/2022
Participating Start Date
1/1/2023
Participating Approval Date
10/31/2022
Last Recertification Date
9/6/2023
Addresses
Street Address
642 ULUKAHIKI STREET, SUITE 300
KAILUA, HI 96734
Billing Address
ADVENTIST HEALTH CASTLE
640 ULUKAHIKI STREET
KAILUA, HI 96734
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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