Provider Demographics
NPI:1619381399
Name:RAINBOW DIALYSIS LLC
Entity Type:Organization
Organization Name:RAINBOW DIALYSIS LLC
Other - Org Name:RAINBOW DIALYSIS-LAHAINA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT KAISER PERMANENTE HAWAII
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-432-5816
Mailing Address - Street 1:711 KAPIOLANI BLVD
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5237
Mailing Address - Country:US
Mailing Address - Phone:808-432-5430
Mailing Address - Fax:808-432-5906
Practice Address - Street 1:305 KEAWE ST
Practice Address - Street 2:STE 503
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-2734
Practice Address - Country:US
Practice Address - Phone:808-661-8372
Practice Address - Fax:808-661-9484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-20
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI122528Medicare Oscar/Certification