Healthcare Provider Details

I. General information

NPI: 1144373754
Provider Name (Legal Business Name): SAMBELLE TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-1472 HOOHONUA ST
PEARL CITY HI
96782-2315
US

IV. Provider business mailing address

98-1472 HOOHONUA ST
PEARL CITY HI
96782-2315
US

V. Phone/Fax

Practice location:
  • Phone: 808-341-2443
  • Fax: 808-454-2402
Mailing address:
  • Phone: 808-341-2443
  • Fax: 808-454-2402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberPUC1851-C
License Number StateHI

VIII. Authorized Official

Name: MR. DENNIS SAMSON
Title or Position: OWNER
Credential:
Phone: 808-341-2443