Coast Guard

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

COAST GUARD

Practice address

1 Jarrett White Rd
Tamc, HI 96859-5001

Phone

(808) 433-9794

Fax

(808) 433-9796

NPI assigned

Mar 6, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Zachary Floyd Smith, HS3

Title

Helth SCVS Technician

Phone

(808) 433-9794

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104956325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 FUNSTON LOOP APT E",
            "address_2": "1 JARRETT WHITE ROAD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968192159",
            "telephone_number": "808-224-7351",
            "fax_number": "808-433-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TAMC",
            "state": "HI",
            "postal_code": "968595001",
            "telephone_number": "808-433-9794",
            "fax_number": "808-433-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST GUARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_middle_name": "FLOYD",
        "authorized_official_title_or_position": "HELTH SCVS TECHNICIAN",
        "authorized_official_telephone_number": "808-433-9794",
        "authorized_official_credential": "HS3"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenya K Cain, M.D.
• Stephen Chan, M.D.
• Ronald Francis Chicoine, LCSW
• Gina Therese Cicero, M.D.
• Ben Lee Clark Sr., DCSW-LCSW
• Mary Stone Connolly, RN
• Glen Prives Corlin, MSW
• Miguel Angel Cruz, DO
• John H Davis II, LPN
• Lee Demotica, R.N.

• Health Service Clinic/Center in Tamc, HI
• Providers in Tamc, HI by specialty
• Health Service Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.