Provider Demographics
NPI:1013972603
Name:UROLOGY CARE, INC.
Entity type:Organization
Organization Name:UROLOGY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:CARLILE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-523-9400
Mailing Address - Street 1:1380 LUSITANA STREET
Mailing Address - Street 2:SUITE #1004
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2449
Mailing Address - Country:US
Mailing Address - Phone:808-523-9400
Mailing Address - Fax:808-526-3080
Practice Address - Street 1:1380 LUSITANA STREET
Practice Address - Street 2:SUITE #1004
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2449
Practice Address - Country:US
Practice Address - Phone:808-523-9400
Practice Address - Fax:808-526-3080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H101178Medicare PIN