Provider Demographics
NPI:1679273890
Name:MEGACARE LLC
Entity Type:Organization
Organization Name:MEGACARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MINERVA
Authorized Official - Middle Name:PURUGGANAN
Authorized Official - Last Name:BORJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-856-1466
Mailing Address - Street 1:291 HOOKAHI ST UNIT 104
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1470
Mailing Address - Country:US
Mailing Address - Phone:808-856-1466
Mailing Address - Fax:808-868-0504
Practice Address - Street 1:291 HOOKAHI ST UNIT 104
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1470
Practice Address - Country:US
Practice Address - Phone:808-856-1466
Practice Address - Fax:808-868-0504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI002541Medicaid