Healthcare Provider Details

I. General information

NPI: 1093868416
Provider Name (Legal Business Name): HAMAKUA HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 01/09/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53-3925 AKONI PULE HWY KOHALA FAMILY HEALTH CENTER
KAPA'AU HI
96755
US

IV. Provider business mailing address

45-549 PLUMERIA ST
HONOKAA HI
96727-6902
US

V. Phone/Fax

Practice location:
  • Phone: 808-889-6236
  • Fax: 808-889-0107
Mailing address:
  • Phone: 808-775-7204
  • Fax: 808-775-9404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: IRENE J CARPENTER
Title or Position: CEO
Credential:
Phone: 808-775-7204