Healthcare Provider Details

I. General information

NPI: 1841962875
Provider Name (Legal Business Name): GEORGE ROMLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2021
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 WAIMANO HOME RD
PEARL CITY HI
96782-1478
US

IV. Provider business mailing address

PO BOX 1196
PEARL CITY HI
96782-8196
US

V. Phone/Fax

Practice location:
  • Phone: 808-454-1411
  • Fax: 808-454-0659
Mailing address:
  • Phone: 808-454-1411
  • Fax: 808-454-0659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: