| Community Clinic Of Maui, Inc. | |
|
250 E Lipoa St Kihei HI 96753-8125 | |
| (808) 871-7772 | |
| Not Available |
| Full Name | Community Clinic Of Maui, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 250 E Lipoa St, Kihei, Hawaii |
| Authorized Official Name and Position | John R Vaz (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8088717772 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Clinic Of Maui, Inc. 1881 Nani St Wailuku HI 96793-1811 Ph: (808) 871-7772 | Community Clinic Of Maui, Inc. 250 E Lipoa St Kihei HI 96753-8125 Ph: (808) 871-7772 |
| NPI Number | 1811687262 |
|---|---|
| Provider Enumeration Date | 05/09/2023 |
| Last Update Date | 05/09/2023 |
| Medicare PECOS PAC ID | 2466365440 |
|---|---|
| Medicare Enrollment ID | O20240216001456 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811687262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Secondary |
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