Organization
WAIMANALO HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY ONEHA APRN, PHD, FAAN (CHIEF EXECUTIVE OFFICER)
(808) 954-7107
Entity
Organization
Contact information
Practice address
41-1347 KALANIANAOLE HWY, WAIMANALO, HI 96795-1247
(808) 954-7107
(808) 259-6449
Mailing address
41-1347 KALANIANAOLE HWY, WAIMANALO, HI 96795-1247
(808) 954-7107
(808) 259-6449
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
W20416724-01
HI
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000212407
BLUES - HATAKEYAMA
HI
05
—
0000228100
—
HI
05
—
0006095000
—
HI
05
—
0007253302
—
HI
05
—
0054794522
—
HI
05
—
0055795200
—
HI
01
—
00A0080927
BLUES - CHAN
HI
01
—
00C0238901
BLUES - CUMMINGS
HI
01
—
00D0094351
HMSA PPO - BHATTACHARYYA
HI
01
—
00D0245664
HMSA - AGULLANA
HI
05
—
049587
—
HI
05
—
04958701
—
HI
Enumeration date
01/23/2007
Last updated
10/22/2020
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