Provider Demographics
NPI:1366025314
Name:HAWAII HOME CARE INC.
Entity Type:Organization
Organization Name:HAWAII HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:CORBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-540-1567
Mailing Address - Street 1:700 BISHOP ST STE 610
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4124
Mailing Address - Country:US
Mailing Address - Phone:808-356-4357
Mailing Address - Fax:808-694-3028
Practice Address - Street 1:24 N CHURCH ST STE 201
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1606
Practice Address - Country:US
Practice Address - Phone:808-550-9440
Practice Address - Fax:808-694-3028
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAWAII HEALTH CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI141-HCAMedicaid