| |
95-5583 Mamalahoa Hwy Na'alehu HI 96772-0070 | |
(808) 929-7311 | |
(808) 961-5678 |
Full Name | |
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Speciality | Clinic/Center |
Location | 95-5583 Mamalahoa Hwy, Na'alehu, Hawaii |
Authorized Official Name and Position | Richard J Taaffe (CEO) |
Authorized Official Contact | 8083263884 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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75-5751 Kuakini Hwy Ste 203 Kailua Kona HI 96740-1753 Ph: (808) 326-3878 | 95-5583 Mamalahoa Hwy Na'alehu HI 96772-0070 Ph: (808) 929-7311 |
NPI Number | 1487602918 |
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Provider Enumeration Date | 05/05/2006 |
Last Update Date | 09/12/2023 |
Medicare PECOS PAC ID | 1557389400 |
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Medicare Enrollment ID | O20230615003680 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487602918 | NPI | - | NPPES |
592502 | Medicaid | HI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Hawaii) | Primary |