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NPI Code Detail

MEDICARE: STATE OF HAWAII DEPARTMENT OF HEALTH

MEDICARE: STATE OF HAWAII DEPARTMENT OF HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225210859
Entity Type Code : Organization
Provider Name (Legal Business Name) : STATE OF HAWAII DEPARTMENT OF HEALTH
Provider Business Mailing Address
First Line : 1250 PUNCHBOWL ST
Second Line : RM 256
City : HONOLULU
State : HI
Zip : 96813-2416
Country : US
Telephone Number : 808-590-7320
Fax Number : 808-586-4745
Provider Business Practice Location Address
First Line : 1700 LANAKILA AVE
Second Line :
City : HONOLULU
State : HI
Zip : 96817-2115
Country : US
Telephone Number : 808-832-3823
Fax Number :
Authorized Official
Title or Position : FINANCIAL RESOURCE SPECIALIST
Name : RAQUEL B. NAKAHARA
Credential :
Telephone Number : 808-590-7320
Provider Enumeration Date : 12/05/2007
Last Update Date : 06/18/2014

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Directions to “STATE OF HAWAII DEPARTMENT OF HEALTH ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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