NPIMap

Organization Active NPI

3G's Direct Care Services Provider LLC

  • In Home Supportive Care Agency
  • Honolulu, HI
National Provider Identifier
1033705603
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
3G'S DIRECT CARE SERVICES PROVIDER LLC
Practice address
1188 Bishop St Ste 3305
Honolulu, HI 96813-3313
Phone
(808) 294-1402
Fax
(877) 297-3821
NPI assigned
Dec 17, 2020
Last updated
Dec 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gloria Quiling Raymundo
Title
Ceo and President
Phone
(808) 294-1402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

1188 Bishop St Ste 3305
Honolulu, HI 96813-3313

Mailing address

1188 Bishop St Ste 3305
Honolulu, HI 96813-3313
Phone (808) 294-1402

Other identifiers 1

IdentifierTypeStateIssuer
800671MedicaidID

Other names 1

  • 3GS DIRECT CARE SERVICES PROVIDER, LLC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
3G's Direct Care Services Provider LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1033705603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1188 BISHOP ST STE 3305",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133313",
            "telephone_number": "808-294-1402",
            "fax_number": "877-297-3821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 BISHOP ST STE 3305",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133313",
            "telephone_number": "808-294-1402",
            "fax_number": "877-297-3821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3G'S DIRECT CARE SERVICES PROVIDER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-14",
        "status": "A",
        "authorized_official_last_name": "RAYMUNDO",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "QUILING",
        "authorized_official_title_or_position": "CEO AND PRESIDENT",
        "authorized_official_telephone_number": "808-294-1402"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800671",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "3GS DIRECT CARE SERVICES PROVIDER, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "3GS DIRECT CARE SERVICES PROVIDER, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.