Provider Demographics
NPI:1720558810
Name:HAWAIIAN PARATRANSIT LLC
Entity Type:Organization
Organization Name:HAWAIIAN PARATRANSIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSPORTATION MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:TANO
Authorized Official - Last Name:ULEP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-740-8868
Mailing Address - Street 1:557 KAULANA ST
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-1920
Mailing Address - Country:US
Mailing Address - Phone:808-740-8868
Mailing Address - Fax:808-633-4701
Practice Address - Street 1:557 KAULANA ST
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1920
Practice Address - Country:US
Practice Address - Phone:808-740-8868
Practice Address - Fax:808-633-4701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH01114799OtherSTATE ID