Healthcare Provider Details

I. General information

NPI: 1215008594
Provider Name (Legal Business Name): KAMAAINA VISION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 ATKINSON DR
HONOLULU HI
96814-4728
US

IV. Provider business mailing address

508 ATKINSON DR
HONOLULU HI
96814-4728
US

V. Phone/Fax

Practice location:
  • Phone: 808-949-7288
  • Fax:
Mailing address:
  • Phone: 808-949-7288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberW20275556-01
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberW20275556-01
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License NumberW20275556-01
License Number StateHI

VIII. Authorized Official

Name: MR. ANTHONY GW MILLER
Title or Position: PRESIDENT
Credential:
Phone: 808-949-7288