Provider Demographics
NPI:1568559524
Name:METROCARE HAWAII, LLC
Entity Type:Organization
Organization Name:METROCARE HAWAII, LLC
Other - Org Name:METROCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:KAPILEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-934-8334
Mailing Address - Street 1:327 KINOOLE ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2918
Mailing Address - Country:US
Mailing Address - Phone:808-934-8334
Mailing Address - Fax:808-933-9304
Practice Address - Street 1:327 KINOOLE ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2918
Practice Address - Country:US
Practice Address - Phone:808-934-8334
Practice Address - Fax:808-933-9304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID540238 01Medicaid