Provider Demographics
NPI:1609818749
Name:KALIHI-PALAMA HEALTH CENTER OPTOMETRY
Entity Type:Organization
Organization Name:KALIHI-PALAMA HEALTH CENTER OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:LANCASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-843-7239
Mailing Address - Street 1:915 N KING ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4544
Mailing Address - Country:US
Mailing Address - Phone:808-841-2791
Mailing Address - Fax:
Practice Address - Street 1:888 N KING ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-4553
Practice Address - Country:US
Practice Address - Phone:808-841-2791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KALIHI-PALAMA HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-12
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI51863101Medicaid
HI51863101Medicaid