LIBERTY DIALYSIS - HAWAII LLC NPI 1467971465

NPI Information

NPI: 1467971465
Provider Name: LIBERTY DIALYSIS - HAWAII LLC

Doing Business As: LIBERTY DIALYSIS - HAWAII ALA MOANA

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
500 ALA MOANA BLVD STE 7302
HONOLULU, HI
ZIP 96813
Phone: (808) 566-6388
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LIBERTY DIALYSIS - HAWAII LLC is an end-stage renal disease (esrd) treatment clinic center in Honolulu, HI. LIBERTY DIALYSIS - HAWAII LLC NPI is 1467971465. The provider is registered as an organization entity type.
The provider Is Doing Business As Liberty Dialysis - Hawaii Ala Moana.

The provider's business location address is:

500 ALA MOANA BLVD STE 7302
HONOLULU, HI
ZIP 96813-930
Phone: (808) 566-6388
Fax: (808) 566-6411

The provider's authorized official is Barry L. Blanton .
The authorized official title is Vice President and has the following contact phone number (781) 699-9000.

The CLIA number assigned to this NPI record is 12D2170673 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/12/2017 and was last updated on 10/19/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	122533	OTHER	HAWAII	PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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