| Organization Name: | MALAMA PONO HEALTH SERVICES |
| NPI Number: | 1003274325 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MISTEE BAILEY-MYRICK (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 4366 Kukui Grove St Suite 207 Lihue |
| State: | HI US |
| Postal Code: | 967662006 |
| Phone Number: | 8082469577 |
| Fax Number: | 8082469588 |
| NPI Enumeration Date: | 02/01/2016 |
| NPI Last Update Date: | 02/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |