Pahala Park LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

PAHALA PARK LLC

Practice address

2240 W Great Neck Rd
Virginia Beach, VA 23451-1506

Phone

(757) 373-8815

NPI assigned

Aug 18, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Michael P Lewis

Title

Owner/Coo

Phone

(757) 373-8815

Specialties & licenses 1

Addresses

Other names 1

• Coastal Event Medical Management Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1093433765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 W GREAT NECK RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234511506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 W GREAT NECK RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234511506",
            "telephone_number": "757-373-8815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAHALA PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/COO",
        "authorized_official_telephone_number": "757-373-8815",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Event Medical Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sharinelle M Pagan-Mercado, DC
• Sherly Marie Pagan-Navarro
• Arlene Floranza Page, PA-C
• Reagan Page
• Alma Reyes Paguio, RN
• Barbara K Paige
• Peter D L Paik, MD
• Bradley Matthew Painter
• Wyketa Denise Painter
• Pal Systems Inc

• Land Ambulance in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Land Ambulance in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.