Provider Demographics
NPI:1639751209
Name:W4H HAWAII
Entity Type:Organization
Organization Name:W4H HAWAII
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHICKNEAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-248-6172
Mailing Address - Street 1:1441 KAPIOLANI BLVD STE 312
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4400
Mailing Address - Country:US
Mailing Address - Phone:808-599-0589
Mailing Address - Fax:
Practice Address - Street 1:1441 KAPIOLANI BLVD STE 312
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4400
Practice Address - Country:US
Practice Address - Phone:808-599-0589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty