MEDICARE: ROWENA C. SALES

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
1	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1760768451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROWENA C. SALES

Provider Business Mailing Address
First Line	:	1921 HANI LN
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96819-3418
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1921 HANI LN
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96819-3418
Country	:	US
Telephone Number	:	808-842-1321
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2011
Last Update Date	:	10/26/2011

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