Provider Demographics
NPI:1932432820
Name:KUPUNARIDE CORPORATION
Entity Type:Organization
Organization Name:KUPUNARIDE CORPORATION
Other - Org Name:KUPUNARIDE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLESPIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-262-7433
Mailing Address - Street 1:522 ULUKOU ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4426
Mailing Address - Country:US
Mailing Address - Phone:808-262-7433
Mailing Address - Fax:888-400-2990
Practice Address - Street 1:522 ULUKOU ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4426
Practice Address - Country:US
Practice Address - Phone:808-262-7433
Practice Address - Fax:888-400-2990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI635609Medicaid