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General NPI Number Information
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NPI Number | 1649226366
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Entity Type | Organization
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Legal Business Name | ISG, INC.
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 11/07/2008
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Provider Practice Location Address
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Address Line | 3472 KANAINA AVE
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City | HONOLULU
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State | HI
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Zip | 96815-4225
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Country | US
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Telephone | 808-732-4622
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Fax | 808-739-5464
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Provider Business Mailing Address
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Address Line | 3472 KANAINA AVE
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City | HONOLULU
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State | HI
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Zip | 96815-4225
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Country | US
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Telephone | 808-732-4622
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Fax | 808-739-5464
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Authorized Official
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Title or Position | PRESIDENT/SECRETARY
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Name | MR. WALTER J. SOARES
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Credential |
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Telephone | 808-732-4622
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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 | W20223302-01
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License Number State | HI
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