Provider Demographics
NPI:1649226366
Name:ISG, INC.
Entity Type:Organization
Organization Name:ISG, INC.
Other - Org Name:ISLAND SKILL GATHERING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:J
Authorized Official - Last Name:SOARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-732-4622
Mailing Address - Street 1:3472 KANAINA AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-4225
Mailing Address - Country:US
Mailing Address - Phone:808-732-4622
Mailing Address - Fax:808-739-5464
Practice Address - Street 1:3472 KANAINA AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-4225
Practice Address - Country:US
Practice Address - Phone:808-732-4622
Practice Address - Fax:808-739-5464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIW20223302-01332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies