Provider Demographics
NPI:1619223617
Name:TRANSITIONAL CARE PARTNERS OF HAWAII, INC.
Entity Type:Organization
Organization Name:TRANSITIONAL CARE PARTNERS OF HAWAII, INC.
Other - Org Name:PALLIATIVE CONNECTIONS OF HAWAII, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRUHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-894-3487
Mailing Address - Street 1:3220 S PEORIA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-2003
Mailing Address - Country:US
Mailing Address - Phone:918-894-3487
Mailing Address - Fax:918-392-4542
Practice Address - Street 1:560 N NIMITZ HWY
Practice Address - Street 2:SUITE 204
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5330
Practice Address - Country:US
Practice Address - Phone:918-894-3487
Practice Address - Fax:918-392-4542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-27
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-13018163W00000X, 163WC0400X, 163WG0000X, 163WH0200X, 163WP0000X, 163WW0000X, 164W00000X, 171M00000X, 363AM0700X, 363L00000X, 363LP2300X, 364SH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty
No163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No163WP0000XNursing Service ProvidersRegistered NursePain ManagementGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Multi-Specialty