Provider Demographics
NPI:1265769301
Name:DAJ MEDICAL EQUIPMENT AND SUPPLIES LLC
Entity type:Organization
Organization Name:DAJ MEDICAL EQUIPMENT AND SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENISSE
Authorized Official - Middle Name:DJ
Authorized Official - Last Name:JOSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CNA
Authorized Official - Phone:808-343-5522
Mailing Address - Street 1:721 MCCULLY ST
Mailing Address - Street 2:732 HAOULI STREET
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-3903
Mailing Address - Country:US
Mailing Address - Phone:808-343-5522
Mailing Address - Fax:
Practice Address - Street 1:721 MCCULLY ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-3903
Practice Address - Country:US
Practice Address - Phone:808-343-5522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIW0547257601332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies