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LONGS DRUG STORES CALIFORNIA, L.L.C.
CH092060 WAIKIKI HEALTH
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Covered Entity Details
Entity Name
WAIKIKI HEALTH
Subdivision Name
Waikiki Health Ohua
Type
HRSA-Funded Health Center
340B ID
CH092060
Entity Address
277 Ohua Ave
Honolulu, HI 96815-3643
Grant Number
H80CS00053
Participating Start Date
4/1/2004
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: LONGS DRUGS # 09813
98 1005 MOANALUA RD
#400
AIEA, HI 96701
Pharmacy Comments
Contract Details
Approval Date
4/6/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Phyllis Dendle, CEO
(808) 537-8443
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/6/2022
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