Healthcare Provider Details

I. General information

NPI: 1376031013
Provider Name (Legal Business Name): EKAHI WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2018
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ALA MOANA BLVD STE 6D
HONOLULU HI
96813
US

IV. Provider business mailing address

500 ALA MOANA BLVD STE 6D
HONOLULU HI
96813-4984
US

V. Phone/Fax

Practice location:
  • Phone: 808-777-4000
  • Fax: 808-465-2505
Mailing address:
  • Phone: 808-777-4000
  • Fax: 808-465-2505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT JOSEPH WALKER
Title or Position: PROGRAM DIRECTOR
Credential: MS, MBA
Phone: 808-777-4000