Healthcare Provider Details

I. General information

NPI: 1871373688
Provider Name (Legal Business Name): OHIMAA HI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 10/02/2023
Certification Date: 09/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N VINEYARD BLVD # A3255613
HONOLULU HI
96817-3950
US

IV. Provider business mailing address

200 N VINEYARD BLVD # A3255613
HONOLULU HI
96817-3950
US

V. Phone/Fax

Practice location:
  • Phone: 762-248-6111
  • Fax:
Mailing address:
  • Phone: 762-248-6111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: AKUA AGYEMAN
Title or Position: CEO
Credential: MD
Phone: 671-686-9860