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General NPI Number Information
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NPI Number | 1023560141
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Entity Type | Organization
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Legal Business Name | DISABLED VETERANS HAWAII LLC
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 4817 NW FRUIT VALLEY ROAD SUITE 100
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City | VANCOUVER
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State | WA
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Zip | 98660
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Country | US
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Telephone | 808-859-3394
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 LAULOA ST
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City | KAILUA
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State | HI
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Zip | 96734-4068
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Country | US
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Telephone | 808-859-3394
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROBERT REYES
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Credential |
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Telephone | 808-859-3394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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