340B Drug Pricing Program Database

Pharmacy Name

5 MINUTE PHARMACY KKV LLC

Pharmacy Address

2229 N. SCHOOL STREET, STE 101
HONOLULU, HI 96819-9681

Pharmacy Comments

Approval Date

4/4/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/24/2021
Pharmacy closed

Covered Entity Signing Official

DAVID DERAUF, Executive Director
(808) 791-9415

Contract Pharmacy Representative

Derek Tengan, Owner
(808) 677-5550

Signed By Date

4/4/2016