| Lanai Community Health Center | |
|
333 Sixth St Lanai City HI 96763 | |
| (808) 565-6919 | |
| Not Available |
| Full Name | Lanai Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 333 Sixth St, Lanai City, Hawaii |
| Authorized Official Name and Position | Diana M Shaw (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8085656919 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lanai Community Health Center Po Box 630142 Lanai City HI 96763-0142 Ph: (808) 565-6919 | Lanai Community Health Center 333 Sixth St Lanai City HI 96763 Ph: (808) 565-6919 |
| NPI Number | 1679754097 |
|---|---|
| Provider Enumeration Date | 11/15/2007 |
| Last Update Date | 03/23/2021 |
| Medicare PECOS PAC ID | 5395828925 |
|---|---|
| Medicare Enrollment ID | O20080205000715 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679754097 | NPI | - | NPPES |
| 509596 | Medicaid | HI | |
| 121854 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Lanai Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 333 Sixth Street, Lanai City, HI 96763 Phone: 808-565-6919 Fax: 808-565-9111 |