Organization
HALE MAKUA
Active
Other names
HALE MAKUA - SUPPLIER
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY LO (CHIEF EXECUTIVE OFFICER)
(808) 877-2761
Entity
Organization
Contact information
Practice address
472 KAULANA ST, KAHULUI, HI 96732-2050
(808) 877-2761
(808) 871-9262
Mailing address
472 KAULANA ST, KAHULUI, HI 96732-2050
(808) 877-2761
(808) 871-9262
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00K0043634
HMSA ENTERALS
HI
Enumeration date
04/19/2007
Last updated
03/24/2017
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