Provider Demographics
NPI:1184952863
Name:HAWAII MEALS ON WHEELS, INC.
Entity type:Organization
Organization Name:HAWAII MEALS ON WHEELS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHIMABUKURO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-988-6747
Mailing Address - Street 1:2728 HUAPALA ST
Mailing Address - Street 2:ROOM 209
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-1656
Mailing Address - Country:US
Mailing Address - Phone:808-988-6747
Mailing Address - Fax:808-988-5719
Practice Address - Street 1:2728 HUAPALA ST
Practice Address - Street 2:ROOM 209
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-1656
Practice Address - Country:US
Practice Address - Phone:808-988-6747
Practice Address - Fax:808-988-5719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI51700501332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI51700501Medicaid