Provider Demographics
NPI:1992811954
Name:HANA HEALTH
Entity type:Organization
Organization Name:HANA HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:M
Authorized Official - Last Name:METZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-248-7515
Mailing Address - Street 1:PO BOX 807
Mailing Address - Street 2:
Mailing Address - City:HANA
Mailing Address - State:HI
Mailing Address - Zip Code:96713-0807
Mailing Address - Country:US
Mailing Address - Phone:808-248-7515
Mailing Address - Fax:808-248-7223
Practice Address - Street 1:4590 HANA HIGHWAY
Practice Address - Street 2:
Practice Address - City:HANA
Practice Address - State:HI
Practice Address - Zip Code:96713
Practice Address - Country:US
Practice Address - Phone:808-248-7515
Practice Address - Fax:808-248-7223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI121822261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI50691Medicare ID - Type UnspecifiedOLD MEDICARE NUMBER
HI12-1822Medicare ID - Type UnspecifiedFQHC NUMBER