| Hawaii Wellness Group Llc | |
|
1314 S King St Ste 1655 Honolulu HI 96814-1950 | |
| (808) 591-9339 | |
| (808) 591-9343 |
| Full Name | Hawaii Wellness Group Llc |
|---|---|
| Speciality | General Practice |
| Location | 1314 S King St Ste 1655, Honolulu, Hawaii |
| Authorized Official Name and Position | Damian Smith (OWNER) |
| Authorized Official Contact | 8085919339 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hawaii Wellness Group Llc 1314 S King St Ste 1653 Honolulu HI 96814-1950 Ph: (808) 591-9339 | Hawaii Wellness Group Llc 1314 S King St Ste 1655 Honolulu HI 96814-1950 Ph: (808) 591-9339 |
| NPI Number | 1699127332 |
|---|---|
| Provider Enumeration Date | 07/06/2016 |
| Last Update Date | 01/28/2019 |
| Medicare PECOS PAC ID | 6204121650 |
|---|---|
| Medicare Enrollment ID | O20160824000675 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699127332 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | John R Magauran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962550194 PECOS PAC ID: 0143368894 Enrollment ID: I20091117000582 |
| Provider Name | Avril Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326417031 PECOS PAC ID: 6002118734 Enrollment ID: I20160112001269 |
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