Provider Demographics
NPI:1558495127
Name:OAHU HEALTHCARE & MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:OAHU HEALTHCARE & MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MERL
Authorized Official - Middle Name:P
Authorized Official - Last Name:CABRADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:DME
Authorized Official - Phone:808-841-3021
Mailing Address - Street 1:92-712 NOHONA ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1135
Mailing Address - Country:US
Mailing Address - Phone:808-841-3021
Mailing Address - Fax:808-841-6825
Practice Address - Street 1:92-712 NOHONA ST
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1135
Practice Address - Country:US
Practice Address - Phone:808-841-3021
Practice Address - Fax:808-841-6825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI547953-03Medicaid