Healthcare Provider Details

I. General information

NPI: 1669817581
Provider Name (Legal Business Name): ISLAND URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2013
Last Update Date: 06/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 KALANIANAOLE HWY 114A
HONOLULU HI
96825-1273
US

IV. Provider business mailing address

6600 KALANIANAOLE HWY 114A
HONOLULU HI
96825-1273
US

V. Phone/Fax

Practice location:
  • Phone: 808-395-2273
  • Fax: 808-394-2273
Mailing address:
  • Phone: 808-395-2273
  • Fax: 808-394-2273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT PAUL RUGGIERI
Title or Position: PRESIDENT
Credential: MD
Phone: 808-395-2273