Healthcare Provider Details

I. General information

NPI: 1881052298
Provider Name (Legal Business Name): PACIFIC ISLAND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2016
Last Update Date: 12/10/2023
Certification Date: 12/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N HOLOPONO ST STE 108
KIHEI HI
96753-6946
US

IV. Provider business mailing address

PO BOX 1977
KIHEI HI
96753-1977
US

V. Phone/Fax

Practice location:
  • Phone: 808-206-9371
  • Fax: 855-270-7441
Mailing address:
  • Phone: 855-968-9371
  • Fax: 808-442-0321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARION HART
Title or Position: BILLING & ADMINISTRATIVE DIRECTOR
Credential:
Phone: 808-283-4300