| Waikiki Health Youth Outreach | |
|
415 Keoniana St Honolulu HI 96815-2018 | |
| (808) 942-5858 | |
| (808) 942-9633 |
| Full Name | Waikiki Health Youth Outreach |
|---|---|
| Speciality | Clinic/Center |
| Location | 415 Keoniana St, Honolulu, Hawaii |
| Authorized Official Name and Position | Sheila Beckham (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8087919302 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waikiki Health Youth Outreach 277 Ohua Ave Honolulu HI 96815-6612 Ph: (808) 791-9355 | Waikiki Health Youth Outreach 415 Keoniana St Honolulu HI 96815-2018 Ph: (808) 942-5858 |
| NPI Number | 1063668473 |
|---|---|
| Provider Enumeration Date | 08/18/2008 |
| Last Update Date | 12/06/2013 |
| Medicare PECOS PAC ID | 9335058536 |
|---|---|
| Medicare Enrollment ID | O20040414001174 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063668473 | NPI | - | NPPES |
| 04701301 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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