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General NPI Number Information
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NPI Number | 1639751209
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Entity Type | Organization
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Legal Business Name | W4H HAWAII
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Dates
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Enumeration Date | 04/23/2021
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Last Update Date | 04/23/2021
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Provider Practice Location Address
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Address Line | 1441 KAPIOLANI BLVD STE 312
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City | HONOLULU
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State | HI
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Zip | 96814-4400
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Country | US
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Telephone | 808-599-0589
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Fax |
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Provider Business Mailing Address
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Address Line | 1441 KAPIOLANI BLVD STE 312
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City | HONOLULU
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State | HI
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Zip | 96814-4400
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Country | US
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Telephone | 808-599-0589
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | GREG CHICKNEAS
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Credential |
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Telephone | 470-248-6172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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