1518012434 NPI number — UNIVERSITY OF HAWAII MAUI COMMUNITY COLLEGE

Table of content: (NPI 1518012434)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518012434 NPI number — UNIVERSITY OF HAWAII MAUI COMMUNITY COLLEGE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF HAWAII MAUI COMMUNITY COLLEGE
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:
6
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:
1518012434
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
310 KAAHUMANU AVE
Provider Second Line Business Mailing Address:
ALLIED HEALTH DEPARTMENT MAUI COMMUNITY COLLEGE
Provider Business Mailing Address City Name:
KAHULUI
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96732-1644
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-984-3250
Provider Business Mailing Address Fax Number:
808-249-2175

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
752 LOWER MAIN STREET
Provider Second Line Business Practice Location Address:
MAUI ORAL HEALTH CENTER INITIATIVE
Provider Business Practice Location Address City Name:
WAILUKU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96793-1454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-244-4559
Provider Business Practice Location Address Fax Number:
808-244-9012
Provider Enumeration Date:
01/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
K
Authorized Official Title or Position:
ALLIED HEALTH DEPARTMENT CHAIR
Authorized Official Telephone Number:
808-984-3250

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 58924401 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com