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General NPI Number Information
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NPI Number | 1649382508
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Entity Type | Organization
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Legal Business Name | NA PU UWAI
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/16/2018
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Provider Practice Location Address
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Address Line | 604 MAUNALOA HIGHWAY, BLDG. C
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City | KAUNAKAKAI
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State | HI
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Zip | 96748-0130
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Country | US
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Telephone | 808-560-3653
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Fax | 808-560-3385
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Provider Business Mailing Address
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Address Line | PO BOX 130 604 MAUNALOA HIGHWAY, BLDG. C
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City | KAUNAKAKAI
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State | HI
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Zip | 96748-0130
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Country | US
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Telephone | 808-560-3653
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Fax | 808-560-3385
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | JERRY J CLEMENTE
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Credential |
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Telephone | 808-560-3656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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