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General NPI Number Information
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NPI Number | 1902993199
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Entity Type | Organization
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Legal Business Name | MANAWA LEA HEALTHCARE SUPPLIES INC
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Dates
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Enumeration Date | 10/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 94-673 KUPUOHI ST
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City | WAIPAHU
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State | HI
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Zip | 96797-5367
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Country | US
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Telephone | 808-484-5635
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Fax | 808-484-5636
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Provider Business Mailing Address
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Address Line | PO BOX 1089
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City | AIEA
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State | HI
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Zip | 96701-1089
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Country | US
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Telephone | 808-484-5635
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Fax | 808-484-5636
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIA MAGDALENA RABAGO
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Credential | REGISTERED NURSE
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Telephone | 808-927-1531
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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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