Provider Demographics
NPI:1619058286
Name:KOKUA NURSES, INC.
Entity Type:Organization
Organization Name:KOKUA NURSES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:ITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-594-2326
Mailing Address - Street 1:1210 ARTESIAN ST
Mailing Address - Street 2:STE 201
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1320
Mailing Address - Country:US
Mailing Address - Phone:808-594-2326
Mailing Address - Fax:808-592-1248
Practice Address - Street 1:1210 ARTESIAN ST
Practice Address - Street 2:STE 201
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1320
Practice Address - Country:US
Practice Address - Phone:808-594-2326
Practice Address - Fax:808-592-1248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIW2031739401251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI51695801Medicaid
HI127011Medicare Oscar/Certification