=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184952863
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAWAII MEALS ON WHEELS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/18/2009
-----------------------------------------------------
Last Update Date | 11/18/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2728 HUAPALA ST ROOM 209
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96822-1656
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-988-6747
-----------------------------------------------------
Fax | 808-988-5719
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2728 HUAPALA ST ROOM 209
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96822-1656
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-988-6747
-----------------------------------------------------
Fax | 808-988-5719
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MS. CLAIRE A SHIMABUKURO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 808-988-6747
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332U00000X
-----------------------------------------------------
Taxonomy Name | Home Delivered Meals
-----------------------------------------------------
License Number | 51700501
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------