| Olakino Health & Wellness Llc | |
|
75-5699 Kopiko St Unit 5 Kailua Kona HI 96740-3651 | |
| (808) 215-6574 | |
| (808) 758-0043 |
| Full Name | Olakino Health & Wellness Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 75-5699 Kopiko St Unit 5, Kailua Kona, Hawaii |
| Authorized Official Name and Position | Anne C Broderson (MANAGING OWNER) |
| Authorized Official Contact | 8082156574 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Olakino Health & Wellness Llc Po Box 286 Holualoa HI 96725-0286 Ph: (808) 215-6574 | Olakino Health & Wellness Llc 75-5699 Kopiko St Unit 5 Kailua Kona HI 96740-3651 Ph: (808) 215-6574 |
| NPI Number | 1316722622 |
|---|---|
| Provider Enumeration Date | 08/28/2023 |
| Last Update Date | 10/13/2024 |
| Medicare PECOS PAC ID | 9335590660 |
|---|---|
| Medicare Enrollment ID | O20240110004170 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316722622 | NPI | - | NPPES |
| 005275 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Anne Broderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992269534 PECOS PAC ID: 1658610571 Enrollment ID: I20190311001949 |
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