Healthcare Provider Details
I. General information
NPI: 1477295038
Provider Name (Legal Business Name): MALAMA HOSPICE & PALLIATIVE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/12/2022
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
75-5706 HANAMA PL STE 103
KAILUA KONA HI
96740-1713
US
IV. Provider business mailing address
75-5706 HANAMA PL STE 103
KAILUA KONA HI
96740-1713
US
V. Phone/Fax
- Phone: 480-202-1674
- Fax:
- Phone: 480-648-9664
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANEIKA
FALCONER
Title or Position: CEO
Credential: M.S/MBA
Phone: 480-202-1674