Healthcare Provider Details

I. General information

NPI: 1265482624
Provider Name (Legal Business Name): WEST HAWAII COMMUNITY HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15-2866 PAHOA VILLAGE RD BLDG C
PAHOA HI
96778-7720
US

IV. Provider business mailing address

75-5751 KUAKINI HWY STE 203
KAILUA KONA HI
96740-1753
US

V. Phone/Fax

Practice location:
  • Phone: 808-965-9711
  • Fax: 808-965-6240
Mailing address:
  • Phone: 808-326-5629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RICHARD J TAAFFE
Title or Position: CEO
Credential:
Phone: 808-326-3884