Provider Demographics
NPI:1558773069
Name:NAVAL HEALTH CLINIC HAWAII
Entity Type:Organization
Organization Name:NAVAL HEALTH CLINIC HAWAII
Other - Org Name:DOD KANEOHE BAY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF DHA POSC
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-536-6650
Mailing Address - Street 1:NAVAL HEALTH CLINIC HAWAII
Mailing Address - Street 2:480 CENTRAL AVE OOR
Mailing Address - City:PEAL HARBOR
Mailing Address - State:HI
Mailing Address - Zip Code:96744
Mailing Address - Country:US
Mailing Address - Phone:808-257-6962
Mailing Address - Fax:808-257-3126
Practice Address - Street 1:NAVAL HEALTH CLINIC
Practice Address - Street 2:BLDG 3089, D STREET
Practice Address - City:KANEOHE BAY
Practice Address - State:HI
Practice Address - Zip Code:96744
Practice Address - Country:US
Practice Address - Phone:808-257-3365
Practice Address - Fax:808-257-1326
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVAL HEALTH CLINIC HAWAII
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-02
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332000000XSuppliersMilitary/U.S. Coast Guard Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2146029OtherPK