Healthcare Provider Details

I. General information

NPI: 1417127507
Provider Name (Legal Business Name): KALIHI-PALAMA HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2008
Last Update Date: 03/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 S KING ST
HONOLULU HI
96813
US

IV. Provider business mailing address

915 N KING ST
HONOLULU HI
96817-4544
US

V. Phone/Fax

Practice location:
  • Phone: 808-791-6315
  • Fax:
Mailing address:
  • Phone: 808-792-5566
  • Fax: 808-792-5577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA LANCASTER
Title or Position: PATIENT ACCOUNTING MANAGER
Credential:
Phone: 808-843-7239