Provider Demographics
NPI:1255812137
Name:WEST HAWAII COMMUNITY HEALTH CENTER, INC.
Entity type:Organization
Organization Name:WEST HAWAII COMMUNITY HEALTH CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:TAAFFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-326-3878
Mailing Address - Street 1:75-5751 KUAKINI HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-1753
Mailing Address - Country:US
Mailing Address - Phone:808-930-0488
Mailing Address - Fax:808-331-6488
Practice Address - Street 1:16-192 PILI MUA STREET
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749-8134
Practice Address - Country:US
Practice Address - Phone:808-930-0488
Practice Address - Fax:808-331-6488
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST HAWAII COMMUNITY HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-28
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1835P0018X
HI3336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI007163Medicaid
HIPHY-929OtherPHARMACY