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General NPI Number Information
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NPI Number | 1851084057
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Entity Type | Organization
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Legal Business Name | HOALA I KE OLA LLC
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Dates
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Enumeration Date | 06/01/2023
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 801 S BERETANIA ST
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City | HONOLULU
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State | HI
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Zip | 96813-2501
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Country | US
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Telephone | 808-753-3935
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1540
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City | HONOLULU
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State | HI
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Zip | 96806-1540
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Country | US
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Telephone | 808-753-3935
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | ROBIN WENTZEL
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Credential |
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Telephone | 808-753-3965
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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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