KA WAI OLA MEDICAL CLINIC LLC


Address: 16-590 Old Volcano Rd, Ste. A, Keaau, HI 96749-8158
Phone: 8087960168

KA WAI OLA MEDICAL CLINIC LLC (NPI# 1487102877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487102877
Entity Type Organization
Organization Name KA WAI OLA MEDICAL CLINIC LLC
Practice Address 16-590 Old Volcano Rd
Ste. A
Keaau
HI 96749-8158
Mailing Address 1695 Auwae Rd
Hilo
HI 96720-6908
Practice Telephone 8087960168
Mailing Telephone 8087960168
Enumeration Date 2016-09-14
Last Update Date 2016-09-14
Authorized Official Name LEILANI KERR (OWNER)
Authorized Official Telephone 8087960168
Authorized Official Credential APRN
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
APRN-1450 HI Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
HI MEDICARE PTAN 11105633 01
HI HMSA PROVIDER 00A0324531 01

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities KA WAI OLA MEDICAL CLINIC LLC 16-590 Old Volcano Rd, Keaau, HI 96749-8158

Office Location

Street Address 16-590 OLD VOLCANO RD
STE. A
City KEAAU
State HI
Zip Code 96749-8158

Providers in the same location

NPI Name Taxonomy Address Enumeration
1992290811 Back To Basics Chiropractic Chiropractor 16-590 Old Volcano Rd, Keaau, HI 96749 2018-06-22

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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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1417592254 Nancy S. Clarke, M.d. LLC Clinic/Center 98-211 Pali Momi St Ste 800, Aiea, HI 96701-4370 2019-11-15
1972071538 Foundaton Research Clinic/Center 1314 S King St Ste 653, Honolulu, HI 96814-1979 2018-11-12
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1346784139 East Maui Medical Clinic, LLP Clinic/Center 4950 Uakea Road, Unit 2, Hana, HI 96713-0278 2016-12-13
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Competitor

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City KEAAU
Zip Code 96749

Improve Information

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Dataset Information

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.

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