Provider Demographics
NPI:1942518022
Name:ISLAND HEART CARE LLC
Entity Type:Organization
Organization Name:ISLAND HEART CARE LLC
Other - Org Name:ARRMAND WOHL
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:MELODY
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:808-854-1162
Mailing Address - Street 1:75-167 HUALALAI RD
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-1714
Mailing Address - Country:US
Mailing Address - Phone:808-769-5225
Mailing Address - Fax:808-769-5099
Practice Address - Street 1:75-167 HUALALAI RD
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1714
Practice Address - Country:US
Practice Address - Phone:808-769-5225
Practice Address - Fax:808-769-5099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-22
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-11161261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty