Provider Demographics
NPI:1558947689
Name:PACIFIC BLOODWORKS, LLC
Entity Type:Organization
Organization Name:PACIFIC BLOODWORKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TAIRAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KALIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-927-9747
Mailing Address - Street 1:2269 AKEUKEU ST
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-1127
Mailing Address - Country:US
Mailing Address - Phone:898-927-9747
Mailing Address - Fax:
Practice Address - Street 1:2269 AKEUKEU ST
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-1127
Practice Address - Country:US
Practice Address - Phone:808-927-9747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty