1740554211 NPI number — HOME BIRTH KAUAI, LLC

Table of content: (NPI 1740554211)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740554211 NPI number — HOME BIRTH KAUAI, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME BIRTH KAUAI, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740554211
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4473 PAHEE ST
Provider Second Line Business Mailing Address:
SUITE L
Provider Business Mailing Address City Name:
LIHUE
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96766-2037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-632-0200
Provider Business Mailing Address Fax Number:
808-632-0201

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4-1558 KUHIO HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAPAA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96746-1856
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-635-2682
Provider Business Practice Location Address Fax Number:
866-423-3332
Provider Enumeration Date:
03/01/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
CLAUDIA
Authorized Official Middle Name:
G
Authorized Official Title or Position:
OWNER/CERTIFIED NURSE MIDWIFE
Authorized Official Telephone Number:
808-635-2682

Provider Taxonomy Codes

  • Taxonomy code: 367A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)