Provider Demographics
NPI:1417580358
Name:MACROPHIL, INC.
Entity Type:Organization
Organization Name:MACROPHIL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELMER
Authorized Official - Middle Name:JAO
Authorized Official - Last Name:CONSULTA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:808-678-9688
Mailing Address - Street 1:PO BOX 893123
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-0123
Mailing Address - Country:US
Mailing Address - Phone:808-678-9688
Mailing Address - Fax:808-677-5958
Practice Address - Street 1:94-239 WAIPAHU DEPOT ST STE 201A
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3072
Practice Address - Country:US
Practice Address - Phone:808-678-9688
Practice Address - Fax:808-677-5958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1467726109Medicaid