Provider Demographics
NPI:1740236322
Name:HOME CARE HAWAII L.L.P
Entity Type:Organization
Organization Name:HOME CARE HAWAII L.L.P
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VP
Authorized Official - Prefix:
Authorized Official - First Name:VITO
Authorized Official - Middle Name:
Authorized Official - Last Name:PONZIO, JR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-672-8631
Mailing Address - Street 1:1675 BROADWAY
Mailing Address - Street 2:SUITE 900
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-4675
Mailing Address - Country:US
Mailing Address - Phone:303-672-8631
Mailing Address - Fax:303-298-0047
Practice Address - Street 1:94-479 UKEE ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-4212
Practice Address - Country:US
Practice Address - Phone:808-677-1288
Practice Address - Fax:808-677-2611
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME CARE HAWAII L.L.P
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251F00000X
HIPHY-592332BP3500X, 333600000X, 3336C0003X, 3336H0001X, 3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIPHY-592OtherRX LICENSE
1203722OtherNCPDP
HI528309-01Medicaid
BH5680271OtherDEA
BH5680271OtherDEA
HIPHY-592OtherRX LICENSE