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Organization

PACIFIC HEALTH INC

Active
Other names
PHI
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DARYLE ANN HO (PRESIDENT)
(808) 833-3414
Entity
Organization

Contact information

Practice address
2875 KOAPAKA ST, HONOLULU, HI 96819-1921
(808) 833-3414
(808) 833-3416
Mailing address
2875 KOAPAKA ST, HONOLULU, HI 96819-1921
(808) 833-3414
(808) 833-3416

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
10685476
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000243493
HMSA PROVIDER #
HI
05
53958801
HI
01
552598-01
MEDICAID WAIVER PROV #
HI
01
98333
KAISER PROVIDER #
HI
Enumeration date
07/07/2005
Last updated
08/22/2020
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