Provider Demographics
NPI:1437194347
Name:PACIFIC RENAL CARE FOUNDATION
Entity Type:Organization
Organization Name:PACIFIC RENAL CARE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEUCTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:KM
Authorized Official - Last Name:COLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-585-4620
Mailing Address - Street 1:2226 LILIHA ST
Mailing Address - Street 2:SUITE 226
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1600
Mailing Address - Country:US
Mailing Address - Phone:808-585-4620
Mailing Address - Fax:808-585-4601
Practice Address - Street 1:203 HOOHANA ST
Practice Address - Street 2:SUITE 201
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2476
Practice Address - Country:US
Practice Address - Phone:808-873-2121
Practice Address - Fax:808-873-2148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service