Provider Demographics
NPI:1952837130
Name:AKAMAI HEALTHCARE SERVICES INC.
Entity Type:Organization
Organization Name:AKAMAI HEALTHCARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-772-3409
Mailing Address - Street 1:949 MAKAMUA PL
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-2012
Mailing Address - Country:US
Mailing Address - Phone:808-455-8746
Mailing Address - Fax:808-455-4676
Practice Address - Street 1:949 MAKAMUA PL
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-2012
Practice Address - Country:US
Practice Address - Phone:808-455-8746
Practice Address - Fax:808-455-4676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-07
Last Update Date:2017-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health