Provider Demographics
NPI:1669817581
Name:ISLAND URGENT CARE LLC
Entity Type:Organization
Organization Name:ISLAND URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:RUGGIERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-395-2273
Mailing Address - Street 1:6600 KALANIANAOLE HWY
Mailing Address - Street 2:114A
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-1273
Mailing Address - Country:US
Mailing Address - Phone:808-395-2273
Mailing Address - Fax:808-394-2273
Practice Address - Street 1:6600 KALANIANAOLE HWY
Practice Address - Street 2:114A
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1273
Practice Address - Country:US
Practice Address - Phone:808-395-2273
Practice Address - Fax:808-394-2273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-06
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care