Healthcare Provider Details

I. General information

NPI: 1063565778
Provider Name (Legal Business Name): GGM HANDI TRANSIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-1361 HIAAI PL
WAIPAHU HI
96797-3809
US

IV. Provider business mailing address

94-1361 HIAAI PL
WAIPAHU HI
96797-3809
US

V. Phone/Fax

Practice location:
  • Phone: 808-291-8667
  • Fax: 808-676-1002
Mailing address:
  • Phone: 808-291-8667
  • Fax: 808-676-1002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberPUC1865-C
License Number StateHI

VIII. Authorized Official

Name: MR. GERONIMO MALABED JR.
Title or Position: OWNER
Credential:
Phone: 808-291-8667