Healthcare Provider Details

I. General information

NPI: 1902181571
Provider Name (Legal Business Name): CHARMANE CATERINA-BOTTORF HEARING AID DEALER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHARMANE RENEE CATERINA HEARING AID DEALER

II. Dates (important events)

Enumeration Date: 10/14/2011
Last Update Date: 10/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 HUKU LII PL SUITE 302
KIHEI HI
96753-7062
US

IV. Provider business mailing address

PO BOX 1205
KIHEI HI
96753-1205
US

V. Phone/Fax

Practice location:
  • Phone: 808-875-4517
  • Fax:
Mailing address:
  • Phone: 808-875-4517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number198
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: