Provider Demographics
NPI:1649782517
Name:KAUAI INDEPENDENT REHABILITATION ASSOCIATES, LLC
Entity type:Organization
Organization Name:KAUAI INDEPENDENT REHABILITATION ASSOCIATES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:V
Authorized Official - Last Name:RHOADES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-977-8241
Mailing Address - Street 1:2-2488 KAUMUALII HWY
Mailing Address - Street 2:
Mailing Address - City:KALAHEO
Mailing Address - State:HI
Mailing Address - Zip Code:96741-8311
Mailing Address - Country:US
Mailing Address - Phone:808-335-5808
Mailing Address - Fax:808-335-5657
Practice Address - Street 1:4-901 KUHIO HWY STE A
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-1549
Practice Address - Country:US
Practice Address - Phone:808-826-6000
Practice Address - Fax:844-965-9830
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAUAI INDEPENDENT REHABILITATION ASSOCIATES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment