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FOODLAND PHARMACY #26
CH091880 BAY CLINIC, INC.
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Covered Entity Details
Entity Name
BAY CLINIC, INC.
Subdivision Name
Hilo Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH091880
Entity Address
1178 Kinoole Street
Bldg. B
Hilo, HI 96720
Grant Number
H80CS00837
Participating Start Date
10/1/2004
Last Recertification Date
2/23/2023
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
FOODLAND PHARMACY #26
Pharmacy Address
2100 KANOELEHUA AVENUE
HILO, HI 96720-6500
Pharmacy Comments
Contract Details
Approval Date
7/8/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/11/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Christian Kimo Alameda, Chief Executive Officer
(808) 930-4083
Contract Pharmacy Representative
Foodland Pharmacy
Ashok Kota, Pharmacy Director
(808) 293-9919 Ext: 8082613211
Signed By Date
7/8/2020
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