Healthcare Provider Details

I. General information

NPI: 1588329114
Provider Name (Legal Business Name): HO'OLA HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 11/08/2021
Certification Date: 11/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 KAMEHAMEHA HWY
PEARL CITY HI
96782-2656
US

IV. Provider business mailing address

92-1141 PANANA ST APT 1402
KAPOLEI HI
96707-3741
US

V. Phone/Fax

Practice location:
  • Phone: 808-391-4522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHEL HANNA
Title or Position: PHARMACIST
Credential:
Phone: 808-391-4522