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BRIAN A CARTER INC.
RWII96766 Malama Pono Health Services
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Covered Entity Details
Entity Name
Malama Pono Health Services
Subdivision Name
Type
Ryan White Part B
340B ID
RWII96766
Entity Address
4370 Kukui Grove Street
Suite 115
Lihue, HI 96766
Grant Number
X07HA00050
Participating Start Date
5/15/2024
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
BRIAN A CARTER INC.
Pharmacy Address
DBA: KALAHEO PHARMACY
1-3845 KAUMUALII HIGHWAY
HANAPEPE, HI 96716
Pharmacy Comments
Contract Details
Approval Date
5/16/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Melanie Rule, CEO
(808) 246-9577
Contract Pharmacy Representative
West side pharmacy
Brian A Carter, Pharmacy
(808) 335-0065
Signed By Date
5/16/2024
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