Provider Demographics
NPI:1992398895
Name:HALE HO'OLA HAMAKUA
Entity Type:Organization
Organization Name:HALE HO'OLA HAMAKUA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JONI
Authorized Official - Middle Name:MU
Authorized Official - Last Name:WALTJEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-932-3110
Mailing Address - Street 1:45-547 PLUMERIA ST
Mailing Address - Street 2:
Mailing Address - City:HONOKAA
Mailing Address - State:HI
Mailing Address - Zip Code:96727-6902
Mailing Address - Country:US
Mailing Address - Phone:808-932-4100
Mailing Address - Fax:
Practice Address - Street 1:45-547 PLUMERIA ST
Practice Address - Street 2:
Practice Address - City:HONOKAA
Practice Address - State:HI
Practice Address - Zip Code:96727-6902
Practice Address - Country:US
Practice Address - Phone:808-932-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty