Healthcare Provider Details

I. General information

NPI: 1750858262
Provider Name (Legal Business Name): MEJ, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2018
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-021 KAMEHAMEHA HWY STE 323
AIEA HI
96701-4908
US

IV. Provider business mailing address

98-021 KAMEHAMEHA HWY STE 207
AIEA HI
96701-4908
US

V. Phone/Fax

Practice location:
  • Phone: 808-797-2111
  • Fax:
Mailing address:
  • Phone: 808-797-2111
  • Fax: 808-797-2112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DAVID BUSENBARK
Title or Position: OWNER
Credential:
Phone: 808-927-6311