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General NPI Number Information
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NPI Number | 1629330550
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Entity Type | Organization
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Legal Business Name | WAIKIKI HEALTH
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Dates
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Enumeration Date | 06/15/2012
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Last Update Date | 02/06/2014
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Provider Practice Location Address
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Address Line | PIER 1 FORREST AVE
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City | HONOLULU
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State | HI
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Zip | 96813-2831
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Country | US
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Telephone | 808-585-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 277 OHUA AVE
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City | HONOLULU
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State | HI
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Zip | 96815-6612
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Country | US
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Telephone | 808-791-9333
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHEILA BECKHAM
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Credential | RD, MPH
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Telephone | 808-791-9302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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