Healthcare Provider Details

I. General information

NPI: 1871531335
Provider Name (Legal Business Name): HONOLULU ORTHOPEDIC SUPPLY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 DILLINGHAM BLVD
HONOLULU HI
96817-4539
US

IV. Provider business mailing address

935 DILLINGHAM BLVD
HONOLULU HI
96817-4539
US

V. Phone/Fax

Practice location:
  • Phone: 808-847-0099
  • Fax: 808-847-1051
Mailing address:
  • Phone: 808-847-0099
  • Fax: 808-847-1051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberABC #090831
License Number StateHI

VIII. Authorized Official

Name: MR. RODNEY M.K. PANG
Title or Position: PRESIDENT
Credential: C.P.O.
Phone: 808-847-0099