PACIFIC ENDOSCOPY CENTER LLC NPI 1841316841

NPI Information

NPI: 1841316841
Provider Name: PACIFIC ENDOSCOPY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 12D1073204

Address:
1029 MAKOLU STREET
SUITE H
PEARL CITY, HI
ZIP 96782
Phone: (808) 456-6420
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PACIFIC ENDOSCOPY CENTER, LLC is an ambulatory surgical clinic center in Pearl City, HI. PACIFIC ENDOSCOPY CENTER, LLC NPI is 1841316841. The provider is registered as an organization entity type.

The provider's business location address is:

1029 MAKOLU STREET
SUITE H
PEARL CITY, HI
ZIP 96782-890
Phone: (808) 456-6420
Fax: (808) 456-6421

The provider's authorized official is Darrell Lee .
The authorized official title is Medical Director and has the following contact phone number (808) 456-6420.

The CLIA number assigned to this NPI record is 12D1073204 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/21/2007 and was last updated on 8/10/2017.

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	261QA1903X	Clinic/Center	Ambulatory Surgical	OHCA FSOF 15	HAWAII	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	12C0001016	MEDICARE OSCAR/CERTIFICATION	HAWAII

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: 5/5/2024

NPI Synchronization or Removal

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