Provider Demographics
NPI:1720131428
Name:GDD HANDI-TRANS
Entity Type:Organization
Organization Name:GDD HANDI-TRANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:DALIGDIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-537-7894
Mailing Address - Street 1:94-601 PALAI ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-4534
Mailing Address - Country:US
Mailing Address - Phone:808-537-7894
Mailing Address - Fax:808-677-5289
Practice Address - Street 1:94-601 PALAI ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-4534
Practice Address - Country:US
Practice Address - Phone:808-537-7894
Practice Address - Fax:808-677-5289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPUC1798-C343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI55245701Medicaid