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General NPI Number Information
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NPI Number | 1699131870
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Entity Type | Organization
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Legal Business Name | IMUA MEDICAL EQUIPMENT AND SUPPLIES,LLC
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Dates
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Enumeration Date | 01/04/2016
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Last Update Date | 01/04/2016
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Provider Practice Location Address
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Address Line | 1916 N KING ST
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City | HONOLULU
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State | HI
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Zip | 96819-3453
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Country | US
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Telephone | 808-853-2337
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Fax | 808-845-2637
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Provider Business Mailing Address
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Address Line | 1916 N KING ST
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City | HONOLULU
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State | HI
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Zip | 96819-3453
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Country | US
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Telephone | 808-853-2337
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Fax | 808-845-2637
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Authorized Official
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Title or Position | MEMBER/ORGANIZER
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Name | JOSEPH RAYMOND TANAEL GO
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Credential |
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Telephone | 808-258-4015
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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 | HI
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