Healthcare Provider Details

I. General information

NPI: 1730183252
Provider Name (Legal Business Name): EMERGENCY MEDICAL SERVICES SYSTEM HAWAII DEPT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 03/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3675 KILAUEA AVE TROTTER BUILDING BASEMENT
HONOLULU HI
96816-2333
US

IV. Provider business mailing address

3675 KILAUEA AVE TROTTER BUILDING BASEMENT
HONOLULU HI
96816-2333
US

V. Phone/Fax

Practice location:
  • Phone: 808-733-9215
  • Fax: 808-733-8332
Mailing address:
  • Phone: 808-733-9215
  • Fax: 808-733-8332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: DR. ALVIN BRONSTEIN
Title or Position: BRANCH CHIEF
Credential:
Phone: 808-733-9210