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ULULANI PHARMACY
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
ULULANI PHARMACY
Pharmacy Address
868 ULULANI ST STE 107
HILO, HI 96720
Pharmacy Comments
Contract Details
Approval Date
10/1/2007
Contract Begin Date
10/1/2007
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/29/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
9/11/2007
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