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WALGREEN OF HAWAII LLC
DSH120006 CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE
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Covered Entity Details
Entity Name
CASTLE MEDICAL CENTER dba ADVENTIST HEALTH CASTLE
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH120006
Entity Address
640 ULUKAHIKI STREET
KAILUA, HI 96734
Medicare Provider Number
120006
Participating Start Date
4/1/2006
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
WALGREEN OF HAWAII LLC
Pharmacy Address
DBA: WALGREENS #16272 SPECIALTY PHARMACY
615 PIIKOI ST STE 105
HONOLULU, HI 96814
Pharmacy Comments
Contract Details
Approval Date
7/28/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jeffrey Nye, VP Finance/CFO
(808) 263-5142
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/28/2016
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