Provider Demographics
NPI:1366025348
Name:THE WAHIAWA CENTER FOR COMMUNITY HEALTH
Entity Type:Organization
Organization Name:THE WAHIAWA CENTER FOR COMMUNITY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:TALANA
Authorized Official - Suffix:
Authorized Official - Credentials:CMRS,CMCS
Authorized Official - Phone:808-622-1618
Mailing Address - Street 1:302 CALIFORNIA AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-1841
Mailing Address - Country:US
Mailing Address - Phone:808-622-1618
Mailing Address - Fax:877-759-6943
Practice Address - Street 1:302 CALIFORNIA AVE STE 106
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-1841
Practice Address - Country:US
Practice Address - Phone:808-622-1618
Practice Address - Fax:877-759-6943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)