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ACCREDO HEALTH GROUP, INC.
CH096040 COMMUNITY CLINIC OF MAUI
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Covered Entity Details
Entity Name
COMMUNITY CLINIC OF MAUI
Subdivision Name
Community Clinic of Maui
Type
HRSA-Funded Health Center
340B ID
CH096040
Entity Address
1881 Nani St
Wailuku, HI 96793-1811
Grant Number
H80CS00722
Participating Start Date
4/1/2004
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP, INC.
Pharmacy Address
677 ALA MOANA BLVD STE 404
HONOLULU, HI 96813-5412
Pharmacy Comments
Contract Details
Approval Date
7/12/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/30/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
BJ OTT, CHIEF EXECUTIVE OFFICER
(808) 872-4018
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
7/12/2019
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