Provider Demographics
NPI:1891759601
Name:PUNAHELE ASSOCIATES, LLC
Entity type:Organization
Organization Name:PUNAHELE ASSOCIATES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:KEKAUOHA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:808-969-9669
Mailing Address - Street 1:82 PUUHONU PLACE
Mailing Address - Street 2:STE 100
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2010
Mailing Address - Country:US
Mailing Address - Phone:808-969-9669
Mailing Address - Fax:808-969-9608
Practice Address - Street 1:82 PUUHONU PLACE
Practice Address - Street 2:STE 100
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2010
Practice Address - Country:US
Practice Address - Phone:808-969-9669
Practice Address - Fax:808-969-9608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0224519OtherHMSA
HI52061001Medicaid
HI0224519OtherHMSA