Healthcare Provider Details

I. General information

NPI: 1689806770
Provider Name (Legal Business Name): PACIFIC CHOICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2009
Last Update Date: 10/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-408 AKOKI ST SUITE 205
WAIPAHU HI
96797-2733
US

IV. Provider business mailing address

94-408 AKOKI ST SUITE 205
WAIPAHU HI
96797-2733
US

V. Phone/Fax

Practice location:
  • Phone: 808-678-3668
  • Fax: 808-678-3669
Mailing address:
  • Phone: 808-678-3668
  • Fax: 808-678-3669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. SARAH M SUZUKI
Title or Position: MANAGING PARTNER
Credential: RN
Phone: 808-678-3668