Provider Demographics
NPI:1902288830
Name:WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INC
Entity type:Organization
Organization Name:WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-697-3300
Mailing Address - Street 1:86-260 FARRINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-3128
Mailing Address - Country:US
Mailing Address - Phone:808-697-3300
Mailing Address - Fax:808-697-3687
Practice Address - Street 1:86-120 FARRINGTON HWY
Practice Address - Street 2:C-301
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-3000
Practice Address - Country:US
Practice Address - Phone:808-696-7021
Practice Address - Fax:808-696-3075
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-27
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty