Healthcare Provider Details

I. General information

NPI: 1447559083
Provider Name (Legal Business Name): KALIHI PALAMA HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2011
Last Update Date: 03/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 S KING ST
HONOLULU HI
96813-4315
US

IV. Provider business mailing address

915 N KING ST
HONOLULU HI
96817-4544
US

V. Phone/Fax

Practice location:
  • Phone: 808-792-5560
  • Fax: 808-792-5577
Mailing address:
  • Phone: 808-791-6315
  • Fax: 808-841-1265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberPHY-797
License Number StateHI

VIII. Authorized Official

Name: EMMANUEL KINTU
Title or Position: CEO/EXECUTIVE DIRECTOR
Credential:
Phone: 808-791-6315