COMMUNITY CLINIC OF MAUI, INC. (NPI# 1013403377) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013403377 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CLINIC OF MAUI, INC. |
| Other Organization Name | MALAMA I KE OLA HEALTH CENTER PHARMACY |
| Practice Address |
1881 Nani St Wailuku HI 96793-1811 |
| Practice Telephone | 8088724078 |
| Practice Fax Number | 8088724029 |
| Mailing Telephone | 8088724078 |
| Mailing Fax Number | 8088724029 |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2018-07-10 |
| Authorized Official Name | BETTY JANE OTT (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 8088724018 |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMUNITY CLINIC OF MAUI, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
PHY-923 | HI | Suppliers |
| Other Name | Type Code |
|---|---|
| Malama I Ke Ola Health Center Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225281793 | Community Clinic of Maui, Inc. | Clinic/Center | 670 Waiale Rd, Wailuku, HI 96793 | 2008-10-28 |
| 1528042561 | Community Clinic of Maui, Inc. | Clinic/Center | 1881 Nani Street, Wailuku, HI 96793 | 2005-12-02 |
| 1437758190 | Community Clinic of Maui, Inc. | Clinic/Center | 1881 Nani St, Wailuku, HI 96793-1811 | 2020-10-22 |
| 1689814055 | Community Clinic of Maui, Inc. | Clinic/Center | 1881 Nani Street, Wailuku, HI 96793 | 2009-02-25 |
| Street Address |
1881 NANI ST |
| City | WAILUKU |
| State | HI |
| Zip Code | 96793-1811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437136769 | Emilie Sumida | Dentist | 1881 Nani St, Wailuku, HI 96793-1811 | 2005-12-28 |
| 1437758190 | Community Clinic of Maui, Inc. | Clinic/Center | 1881 Nani St, Wailuku, HI 96793-1811 | 2020-10-22 |
| 1952925125 | Joseph Irvin Wright Jr. | Student in an Organized Health Care Education/Training Program | 1881 Nani St, Wailuku, HI 96793-1811 | 2020-06-03 |
| 1689202160 | Jason Lee | Student in an Organized Health Care Education/Training Program | 1881 Nani St, Wailuku, HI 96793-1811 | 2020-03-30 |
| 1063973949 | Jose Luis Villa Jr. | Student in an Organized Health Care Education/Training Program | 1881 Nani St, Wailuku, HI 96793-1811 | 2019-03-25 |
| 1780176784 | David Kirsch | Student in an Organized Health Care Education/Training Program | 1881 Nani St, Wailuku, HI 96793-1811 | 2018-06-05 |
| 1104317122 | Renee Sattler | Dietitian, Registered | 1881 Nani St, Wailuku, HI 96793-1811 | 2018-05-24 |
| 1740720291 | Xu Yao | Student in an Organized Health Care Education/Training Program | 1881 Nani St, Wailuku, HI 96793-1811 | 2017-03-02 |
| 1154872273 | Heather Milovina | Advanced Practice Midwife | 1881 Nani St, Wailuku, HI 96793-1811 | 2016-10-24 |
| 1720453640 | Daniel Nead | Psychologist | 1881 Nani St, Wailuku, HI 96793-1811 | 2015-12-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699384701 | Laura Covey | Massage Therapist | Wailuku Community Acupuncture, 33 Central Ave, Wailuku, HI 96793 | 2020-07-24 |
| 1750902839 | Massage Therapy and Wellness of Hawai, LLC | Massage Therapist | Massage Therapy and Wellness of Hawaii, 219 Hookahi St Suite 108, Wailuku, HI 96793 | 2020-04-30 |
| 1790329084 | Milba Rojas Melchor | Technician | 932 Wailupe Drive, Wailuku, HI 96793 | 2019-10-30 |
| 1669973863 | Chad Adolpho | Massage Therapist | 95 Mahalani Street, Room 21, Wailuku, HI 96793 | 2018-02-22 |
| 1548785520 | Hookaulike Wellness LLC | Registered Nurse | 720 Kealii Drive, Wailuku, HI 96793 | 2017-08-10 |
| 1932585072 | Back & Body Clinic of Hi, LLC | Massage Therapist | 81 Central Avenue, Wailuku, HI 96793 | 2015-07-30 |
| 1558765719 | Maui Cancer Clinic, Inc. | Clinic/Center | 24 North Church Street Suite 308, Wailuku, HI 96793 | 2014-10-17 |
| 1609275262 | Maui Memorial Medical Center | General Acute Care Hospital | 85 Maui Lani Parkway, Wailuku, HI 96793 | 2014-08-20 |
| 1558780072 | Mental Health Kokua | Community/Behavioral Health | 503 -a Ua Place, Wailuku, HI 96793 | 2014-04-11 |
| 1538584545 | Mental Health Kokua | Assisted Living Facility | 503 Ua Pl, Iao Valley, Wailuku, Maui, HI 96793 | 2014-02-27 |
| Find all providers in zip 96793 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215411533 | Pacific Pharmacy Solutions LLC | Pharmacy | 95 Mahalani St Rm 10, Wailuku, HI 96793-2521 | 2018-09-21 |
| 1750402228 | Kaiser Foundation Health Plan Inc | Pharmacy | 55 Maui Lani Pkwy, Wailuku, HI 96793-2416 | 2007-04-03 |
| 1699816058 | Kaiser Foundation Health Plan Inc | Pharmacy | 80 Mahalani St, Wailuku, HI 96793-2531 | 2007-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801430707 | Alan Nagakura | Pharmacy | 667 Kanoelehua Ave, Hilo, HI 96720-4592 | 2019-11-04 |
| 1437689957 | Kalihi-palama Health Center | Pharmacy | 710 N King St, Honolulu, HI 96817-5769 | 2017-06-18 |
| 1114132776 | Straub Clinic & Hospital (lanai Clinic Pharmacy) | Pharmacy | 628 B Seventh St, Lanai City, HI 96763 | 2007-05-14 |
| 1033230420 | Kaiser Foundation Health Plan Inc | Pharmacy | 95 660 Lanikuhani Ave, Mililani, HI 96789 | 2007-04-03 |
| 1740322478 | Kaiser Foundation Health Plan Inc | Pharmacy | 75 184 Hualalia Rd, Kailua-kona, HI 96740 | 2007-02-12 |
| 1114068574 | Kaiser Foundation Health Plan Inc | Pharmacy | 94 1480 Moaniani St, Waipahu, HI 96797 | 2007-02-09 |
| 1366583718 | Kaiser Foundation Health Plan Inc | Pharmacy | 201 Hamakua Dr Bldg B, Kailua, HI 96734-3984 | 2007-02-09 |
| 1780639724 | Kaiser Foundation Health Plan Inc | Pharmacy | 2828 Pa A St, Ste 2400, Honolulu, HI 96819 | 2006-05-24 |
| 1134773344 | Waimanalo Health Center | Pharmacy | 41-1295 Kalanianaole Hwy, Waimanalo, HI 96795 | 2019-07-25 |
| 1033516836 | Waikiki Health Center Pharmacy 2 | Pharmacy | 935 Makahiki Way, Honolulu, HI 96826-2896 | 2014-11-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.