Provider Demographics
NPI:1639124654
Name:PT HAWAII, INC
Entity Type:Organization
Organization Name:PT HAWAII, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:GROVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-227-4900
Mailing Address - Street 1:91-2135 FORT WEAVER ROAD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-1929
Mailing Address - Country:US
Mailing Address - Phone:808-676-5331
Mailing Address - Fax:808-671-2931
Practice Address - Street 1:91-2139 FORT WEAVER RD
Practice Address - Street 2:202
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-3607
Practice Address - Country:US
Practice Address - Phone:808-677-5110
Practice Address - Fax:808-671-2931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT2025225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000231688OtherHMSA QUEST
HI00A0231686OtherBCBS/HMSA
HI52633701Medicaid
HI0000231688OtherHMSA 65C
HI=========OtherKASIER PEMANTE
HI00A0231686OtherBCBS/HMSA
HI=========OtherTRIWEST
HI52633701Medicaid
HI=========OtherALOHACARE
HI=========OtherUNITED HEALTH CARE