Healthcare Provider Details

I. General information

NPI: 1073439964
Provider Name (Legal Business Name): 808 MED-KARE TRANSPORT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-1106 HAMANA ST APT D
EWA BEACH HI
96706-4113
US

IV. Provider business mailing address

91-1106 HAMANA ST APT D
EWA BEACH HI
96706-4113
US

V. Phone/Fax

Practice location:
  • Phone: 808-830-0965
  • Fax:
Mailing address:
  • Phone: 808-830-0965
  • 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: KELLY H FLORES
Title or Position: OWNER
Credential:
Phone: 808-384-6602