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General NPI Number Information
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NPI Number | 1851165450
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Entity Type | Organization
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Legal Business Name | PACIFIC HAIR WAIKIKI, LLC
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Dates
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Enumeration Date | 11/14/2023
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 438 HOBRON LN UNIT 109B
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City | HONOLULU
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State | HI
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Zip | 96815-1233
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Country | US
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Telephone | 808-260-4995
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Fax | 808-443-0812
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Provider Business Mailing Address
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Address Line | 6927 POMAIKAI ST
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City | KAPAA
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State | HI
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Zip | 96746-9355
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Country | US
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Telephone | 808-631-3582
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | MS. RAMATU YANIE SESAY CARTER
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Credential | BSC
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Telephone | 808-631-3582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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