Provider Demographics
NPI:1639323405
Name:KEVIN MCHUGH OPTICAL LLC
Entity Type:Organization
Organization Name:KEVIN MCHUGH OPTICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:MCHUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-327-2020
Mailing Address - Street 1:73-5618 MAIAU ST
Mailing Address - Street 2:SUITE A201
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-2616
Mailing Address - Country:US
Mailing Address - Phone:808-327-2020
Mailing Address - Fax:
Practice Address - Street 1:73-5618 MAIAU ST
Practice Address - Street 2:SUITE A201
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2616
Practice Address - Country:US
Practice Address - Phone:808-327-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDIO238156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty