Provider Demographics
NPI:1710056825
Name:ORTHOPEDIC CARE HI, INC.
Entity Type:Organization
Organization Name:ORTHOPEDIC CARE HI, INC.
Other - Org Name:THE BRACE SHOP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRANDEE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-695-6470
Mailing Address - Street 1:627 SOUTH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5050
Mailing Address - Country:US
Mailing Address - Phone:808-695-6470
Mailing Address - Fax:808-695-6499
Practice Address - Street 1:627 SOUTH ST STE 100
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5050
Practice Address - Country:US
Practice Address - Phone:808-695-6470
Practice Address - Fax:808-695-6499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIDME-0194OtherDURABLE MEDICAL EQUIPMENT LICENSE
HIGE-210-870-6816-01OtherHAWAII TAX ID