Provider Demographics
NPI:1164001954
Name:HAMAKUA HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:HAMAKUA HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-775-7204
Mailing Address - Street 1:45-549 PLUMERIA ST
Mailing Address - Street 2:
Mailing Address - City:HONOKAA
Mailing Address - State:HI
Mailing Address - Zip Code:96727-6902
Mailing Address - Country:US
Mailing Address - Phone:808-775-7204
Mailing Address - Fax:808-775-9404
Practice Address - Street 1:65-1190 MAMALAHOA HWY
Practice Address - Street 2:SUITES 1, 2, 3 AND 12
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743
Practice Address - Country:US
Practice Address - Phone:808-775-7204
Practice Address - Fax:808-775-9404
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAMAKUA HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)