Provider Demographics
NPI:1841463080
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:J
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
Mailing Address - Street 2:STE 203
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-1705
Mailing Address - Country:US
Mailing Address - Phone:808-326-3883
Mailing Address - Fax:808-329-9370
Practice Address - Street 1:81 6627 MAMALAHOA HWY
Practice Address - Street 2:STE 106
Practice Address - City:KEALAKEKUA
Practice Address - State:HI
Practice Address - Zip Code:96750
Practice Address - Country:US
Practice Address - Phone:808-323-8005
Practice Address - Fax:808-323-2255
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST HAWAII COMMUNITY HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-09
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty