Provider Demographics
NPI:1760810063
Name:FIRSTVITALS HEALTH AND WELLNESS INC
Entity Type:Organization
Organization Name:FIRSTVITALS HEALTH AND WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:GIN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-589-0100
Mailing Address - Street 1:1288 ALA MOANA BLVD
Mailing Address - Street 2:27E
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4206
Mailing Address - Country:US
Mailing Address - Phone:808-589-0100
Mailing Address - Fax:
Practice Address - Street 1:1288 ALA MOANA BLVD
Practice Address - Street 2:27E
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4206
Practice Address - Country:US
Practice Address - Phone:808-589-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 16889174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty