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54-3858 Akoni Pule Hwy Kapa'au HI 96755-9675 | |
(808) 726-2461 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 54-3858 Akoni Pule Hwy, Kapa'au, Hawaii |
Authorized Official Name and Position | Charlotte Charfen (CEO) |
Authorized Official Contact | 8087262461 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 811 Kapaau HI 96755-0811 Ph: (808) 726-2461 | 54-3858 Akoni Pule Hwy Kapa'au HI 96755-9675 Ph: (808) 726-2461 |
NPI Number | 1497325161 |
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Provider Enumeration Date | 06/25/2021 |
Last Update Date | 12/05/2022 |
Medicare PECOS PAC ID | 3779965967 |
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Medicare Enrollment ID | O20220804001605 |
Identifier | Type | State | Issuer |
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1497325161 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Charlotte N Charfen |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1144264052 PECOS PAC ID: 3577467471 Enrollment ID: I20150717000651 |