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ACCREDO HEALTH GROUP, INC.
CH09341C KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES
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Covered Entity Details
Entity Name
KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES
Subdivision Name
KKV Wellness Center
Type
HRSA-Funded Health Center
340B ID
CH09341C
Entity Address
2229 N School St
Honolulu, HI 96819-2588
Grant Number
H80CS00776
Participating Start Date
10/1/2014
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP, INC.
Pharmacy Address
2 BOULDEN CIR STE 1
NEW CASTLE, DE 19720-3492
Pharmacy Comments
Contract Details
Approval Date
10/15/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/22/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
DAVID DERAUF, Executive Director
(808) 791-9415
Contract Pharmacy Representative
Accredo
Casey Spiess, Director, 340B Business Development
(314) 486-5839
Signed By Date
10/15/2018
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