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4856 E Eha Way Apt A Ewa Beach HI 96706-3012 | |
| (504) 644-1912 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4856 E Eha Way Apt A, Ewa Beach, Hawaii |
| Authorized Official Name and Position | Nathaniel Bossick (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5046441912 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Rainbow Health 4586a E Eha Way Ewa Beach HI 96706 Ph: () - | 4856 E Eha Way Apt A Ewa Beach HI 96706-3012 Ph: (504) 644-1912 |
| NPI Number | 1760162663 |
|---|---|
| Provider Enumeration Date | 07/25/2023 |
| Last Update Date | 01/10/2025 |
| Certification Date | 01/07/2025 |
| Medicare PECOS PAC ID | 1759829906 |
|---|---|
| Medicare Enrollment ID | O20240819003077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760162663 | NPI | - | NPPES |
| Provider Name | Nathaniel R Bossick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952772881 PECOS PAC ID: 2668910811 Enrollment ID: I20240923002187 |
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