Provider Demographics
NPI:1851165450
Name:PACIFIC HAIR WAIKIKI, LLC
Entity Type:Organization
Organization Name:PACIFIC HAIR WAIKIKI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RAMATU
Authorized Official - Middle Name:YANIE
Authorized Official - Last Name:SESAY CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:BSC
Authorized Official - Phone:808-631-3582
Mailing Address - Street 1:6927 POMAIKAI ST
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-9355
Mailing Address - Country:US
Mailing Address - Phone:808-631-3582
Mailing Address - Fax:
Practice Address - Street 1:438 HOBRON LN UNIT 109B
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1233
Practice Address - Country:US
Practice Address - Phone:808-260-4995
Practice Address - Fax:808-443-0812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier