Healthcare Provider Details

I. General information

NPI: 1619223617
Provider Name (Legal Business Name): TRANSITIONAL CARE PARTNERS OF HAWAII, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2012
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 N NIMITZ HWY SUITE 204
HONOLULU HI
96817-5330
US

IV. Provider business mailing address

3220 S PEORIA AVE SUITE 101
TULSA OK
74105-2003
US

V. Phone/Fax

Practice location:
  • Phone: 918-894-3487
  • Fax: 918-392-4542
Mailing address:
  • Phone: 918-894-3487
  • Fax: 918-392-4542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberMD-13018
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberMD-13018
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberMD-13018
License Number StateHI
# 4
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberMD-13018
License Number StateHI
# 5
Primary TaxonomyN
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License NumberMD-13018
License Number StateHI
# 6
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberMD-13018
License Number StateHI
# 7
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberMD-13018
License Number StateHI
# 8
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberMD-13018
License Number StateHI
# 9
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMD-13018
License Number StateHI
# 10
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberMD-13018
License Number StateHI
# 11
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberMD-13018
License Number StateHI
# 12
Primary TaxonomyN
Taxonomy Code364SH0200X
TaxonomyHome Health Clinical Nurse Specialist
License NumberMD-13018
License Number StateHI

VIII. Authorized Official

Name: ROGER A BRUHN
Title or Position: DIRECTOR
Credential:
Phone: 918-894-3487