Healthcare Provider Details

I. General information

NPI: 1346654001
Provider Name (Legal Business Name): HULU MAKUA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2014
Last Update Date: 06/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 KAPAHULU AVE STE 408
HONOLULU HI
96816-1332
US

IV. Provider business mailing address

1029 KAPAHULU AVE STE 408
HONOLULU HI
96816-1332
US

V. Phone/Fax

Practice location:
  • Phone: 808-733-5111
  • Fax: 808-733-5122
Mailing address:
  • Phone: 808-733-5111
  • Fax: 808-733-5122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateHI

VIII. Authorized Official

Name: SHARON S MIYAKI
Title or Position: REGISTERED AGENT / MEMBER
Credential:
Phone: 808-733-5111