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General NPI Number Information
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NPI Number | 1245616416
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 11/15/2016
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Provider Practice Location Address
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Address Line | 346 WAIANUENUE AVE
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City | HILO
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State | HI
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Zip | 96720
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Country | US
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Telephone | 808-319-2939
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Fax | 808-319-2940
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Provider Business Mailing Address
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Address Line | 346 WAIANUENUE AVE
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City | HILO
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State | HI
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Zip | 96720
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Country | US
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Telephone | 808-319-2939
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Fax | 808-319-2940
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CATHY REYES
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Credential |
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Telephone | 808-319-2939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | MD-16511
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License Number State | HI
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