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PUNA PLANTATION HAWAII, LTD.
CH092464C WEST HAWAII COMMUNITY HEALTH CENTER, INC
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Covered Entity Details
Entity Name
WEST HAWAII COMMUNITY HEALTH CENTER, INC
Subdivision Name
WHCHC - WAIKOLOA FAMILY MEDICAL
Type
HRSA-Funded Health Center
340B ID
CH092464C
Entity Address
68-1845 WAIKOLOA RD
STE 207
WAIKOLOA, HI 96738
Grant Number
H80CS06640
Participating Start Date
10/1/2012
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
PUNA PLANTATION HAWAII, LTD.
Pharmacy Address
DBA KTA WAIKOLOA VILLAGE PHARMACY
68-3916 PANIOLO AVE
WAIKOLOA, HI 96738
Pharmacy Comments
Contract Details
Approval Date
7/8/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
RICHARD J. TAAFFE, CEO
(808) 326-3878
Contract Pharmacy Representative
KTA Superstores
kerri okamura, director of pharmacy operations
(808) 959-4575 Ext: 3349
Signed By Date
7/8/2024
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