Provider Demographics
NPI:1417391814
Name:EAST HAWAII MIDWIFE SERVICE
Entity Type:Organization
Organization Name:EAST HAWAII MIDWIFE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:CAROLYN
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:808-936-4068
Mailing Address - Street 1:13-3553 LUANA ST
Mailing Address - Street 2:
Mailing Address - City:PAHOA
Mailing Address - State:HI
Mailing Address - Zip Code:96778-8417
Mailing Address - Country:US
Mailing Address - Phone:808-936-4068
Mailing Address - Fax:808-935-9768
Practice Address - Street 1:13-3591 LUANA ST
Practice Address - Street 2:
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778-8417
Practice Address - Country:US
Practice Address - Phone:808-936-4068
Practice Address - Fax:808-965-9768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN 1123261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing