Healthcare Provider Details

I. General information

NPI: 1841463080
Provider Name (Legal Business Name): WEST HAWAII COMMUNITY HEALTH CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 01/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 6627 MAMALAHOA HWY STE 106
KEALAKEKUA HI
96750
US

IV. Provider business mailing address

75 5751 KUAKINI HWY STE 203
KAILUA KONA HI
96740-1705
US

V. Phone/Fax

Practice location:
  • Phone: 808-323-8005
  • Fax: 808-323-2255
Mailing address:
  • Phone: 808-326-3883
  • Fax: 808-329-9370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD J TAAFFE
Title or Position: CEO
Credential:
Phone: 808-326-3878