| Administration | |
|
450 Kilauea Ave Ste 105 Hilo HI 96720-3089 | |
| (808) 961-4071 | |
| (808) 961-5678 |
| Full Name | Administration |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 450 Kilauea Ave Ste 105, Hilo, Hawaii |
| Authorized Official Name and Position | Richard Taaffe (CEO) |
| Authorized Official Contact | 8083263878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Administration 75-5751 Kuakini Hwy Ste 203 Kailua Kona HI 96740-1753 Ph: (808) 961-4071 | Administration 450 Kilauea Ave Ste 105 Hilo HI 96720-3089 Ph: (808) 961-4071 |
| NPI Number | 1053955120 |
|---|---|
| Provider Enumeration Date | 11/01/2019 |
| Last Update Date | 07/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053955120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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