Provider Demographics
NPI:1710642376
Name:WEST HAWAII COMMUNITY HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:WEST HAWAII COMMUNITY HEALTH CENTER, INC.
Other - Org Name:HAWAII ISLAND COMMUNITY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:TAAFFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-326-3884
Mailing Address - Street 1:450 KILAUEA AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3089
Mailing Address - Country:US
Mailing Address - Phone:808-961-4082
Mailing Address - Fax:
Practice Address - Street 1:305 WAILUKU DR STE 2A
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2488
Practice Address - Country:US
Practice Address - Phone:808-965-3047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)