Healthcare Provider Details

I. General information

NPI: 1053257386
Provider Name (Legal Business Name): ISLAND LINK LOGISTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6769 NUUULI STREET
PAGO PAGO AS
96799
US

IV. Provider business mailing address

6769 NUUULI STREET
PAGO PAGO AS
96799
US

V. Phone/Fax

Practice location:
  • Phone: 684-733-9500
  • Fax:
Mailing address:
  • Phone: 684-733-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID MONTGOMERY BETHAM
Title or Position: PRESIDENT
Credential:
Phone: 684-733-9500