Provider Demographics
NPI:1780247452
Name:PROSTHETIC & ORTHOTIC ASSOCIATES OF HAWAII
Entity type:Organization
Organization Name:PROSTHETIC & ORTHOTIC ASSOCIATES OF HAWAII
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, REGISTERED AGENT
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHNAIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:KINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-245-7770
Mailing Address - Street 1:1314 S KING ST STE 1564
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2072
Mailing Address - Country:US
Mailing Address - Phone:808-375-4790
Mailing Address - Fax:
Practice Address - Street 1:1314 S KING ST STE 1564
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2072
Practice Address - Country:US
Practice Address - Phone:808-597-1773
Practice Address - Fax:808-597-1772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier