Provider Demographics
NPI:1497810451
Name:STAT MEDICAL, INC.
Entity Type:Organization
Organization Name:STAT MEDICAL, INC.
Other - Org Name:STAT MEDICAL, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-848-4663
Mailing Address - Street 1:1804 HAU ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-3253
Mailing Address - Country:US
Mailing Address - Phone:808-848-4663
Mailing Address - Fax:808-848-0697
Practice Address - Street 1:1804 HAU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-3253
Practice Address - Country:US
Practice Address - Phone:808-848-4663
Practice Address - Fax:808-848-0697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIW2035225401332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI01244001Medicaid
HI192206OtherSUMMERLIN
HI192206OtherHMA, INC.
HIA013134OtherHAWAII MEDICAL SVC ASSN.
HI01244001Medicaid