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General NPI Number Information
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NPI Number | 1881967438
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Entity Type | Organization
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Legal Business Name | PACBLU
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Dates
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Enumeration Date | 02/13/2012
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 1357 KAPIOLANI BLVD STE 1015
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City | HONOLULU
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State | HI
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Zip | 96814-4549
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Country | US
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Telephone | 808-955-2900
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Fax | 808-955-2925
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Provider Business Mailing Address
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Address Line | 1357 KAPIOLANI BLVD STE 1015
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City | HONOLULU
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State | HI
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Zip | 96814-4549
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Country | US
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Telephone | 808-955-2900
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Fax | 808-955-2925
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Authorized Official
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Title or Position | CFO/COO
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Name | MR. WILLIAM JAMES WEAVER
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Credential |
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Telephone | 808-955-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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