Provider Demographics
NPI:1982338794
Name:KUUAHI MOBILE MEDICAL
Entity Type:Organization
Organization Name:KUUAHI MOBILE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-769-9556
Mailing Address - Street 1:PO BOX 11510
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96721-6510
Mailing Address - Country:US
Mailing Address - Phone:808-366-6106
Mailing Address - Fax:
Practice Address - Street 1:101 AUPUNI ST STE 313
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4262
Practice Address - Country:US
Practice Address - Phone:808-366-6106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-16
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center