Provider Demographics
NPI:1972043388
Name:LICE CLINICS OF HAWAII
Entity Type:Organization
Organization Name:LICE CLINICS OF HAWAII
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:BARRIE
Authorized Official - Last Name:DESMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-283-4247
Mailing Address - Street 1:300 OHUKAI RD
Mailing Address - Street 2:B-319
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7040
Mailing Address - Country:US
Mailing Address - Phone:808-866-9060
Mailing Address - Fax:
Practice Address - Street 1:300 OHUKAI RD
Practice Address - Street 2:B-319
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7040
Practice Address - Country:US
Practice Address - Phone:808-866-9060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty