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LONGS DRUG STORES CALIFORNIA, L.L.C.
NH5022A Hui Malama Ola Na Oiwi
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Covered Entity Details
Entity Name
Hui Malama Ola Na Oiwi
Subdivision Name
Family Medicine Clinic
Type
Native Hawaiian Health Care Program
340B ID
NH5022A
Entity Address
82 Puuhonu Place
STE 209
Hilo, HI 96720
Grant Number
H1CCS00013
Participating Start Date
4/1/2020
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
LONGS DRUG STORES CALIFORNIA, L.L.C.
Pharmacy Address
DBA: LONGS DRUGS #07098
15-1454 KAHAKAI BLVD.
PAHOA, HI 96778
Pharmacy Comments
Contract Details
Approval Date
4/12/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sandra Lehua Andrade, Executive Director
(808) 969-9220
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/12/2022
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