Hawaii Medride LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

HAWAII MEDRIDE LLC

Practice address

91-220 Paiaha PL
Kapolei, HI 96707-3125

Phone

(808) 366-0085

NPI assigned

Mar 7, 2019

Last updated

Mar 7, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justin Francisco Gamboa

Title

Member

Phone

(808) 366-0085

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551916800000",
    "number": "1093273278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-220 PAIAHA PL",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967073125",
            "telephone_number": "808-366-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-220 PAIAHA PL",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967073125",
            "telephone_number": "808-366-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWAII MEDRIDE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-07",
        "last_updated": "2019-03-07",
        "status": "A",
        "authorized_official_last_name": "GAMBOA",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "FRANCISCO",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "808-366-0085"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Kapolei, HI
• Providers in Kapolei, HI by specialty
• Non-emergency Medical Transport (VAN) in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.