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General NPI Number Information
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NPI Number | 1477875318
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Entity Type | Organization
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Legal Business Name | MALAMA OHANA NURSING AND REHAB CENTER
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Dates
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Enumeration Date | 02/19/2010
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Last Update Date | 04/28/2021
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Provider Practice Location Address
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Address Line | 3288 MOANALUA RD
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City | HONOLULU
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State | HI
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Zip | 96819-1469
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Country | US
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Telephone | 808-432-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 3288 MOANALUA RD
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City | HONOLULU
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State | HI
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Zip | 96819-1469
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Country | US
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Telephone | 808-432-0000
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Fax |
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Authorized Official
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Title or Position | VP-CHIEF FINANCIAL OFFICER
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Name | THOMAS J RISSE
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Credential |
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Telephone | 808-432-5275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 78-N
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License Number State | HI
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