NPIMap

Organization Active NPI

Liberty Dialysis Hawaii LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lahaina, HI
National Provider Identifier
1487037206
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
1060527 Issued in WA
Legal business name
LIBERTY DIALYSIS HAWAII LLC
Practice address
10 Hoohui Rd Ste 100
Lahaina, HI 96761-9257
Phone
(808) 669-6628
Fax
(808) 669-1272
NPI assigned
Jun 30, 2015
Last updated
Jun 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Authorized official

Name
Mrs. Melissa-Ann Souza
Title
Director of Operations
Phone
(808) 856-2102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 1060527 WA Primary

Addresses

Primary practice location

10 Hoohui Rd Ste 100
Lahaina, HI 96761-9257

Mailing address

10 Hoohui Rd Ste 100
Lahaina, HI 96761-9257
Phone (808) 669-6628

National Provider Directory

National Provider Directory
Tax ID family
Ability Network22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1487037206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 HOOHUI RD STE 100",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "967619257",
            "telephone_number": "808-669-6628",
            "fax_number": "808-669-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HOOHUI RD STE 100",
            "city": "LAHAINA",
            "state": "HI",
            "postal_code": "967619257",
            "telephone_number": "808-669-6628",
            "fax_number": "808-669-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DIALYSIS HAWAII LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-30",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "SOUZA",
        "authorized_official_first_name": "MELISSA-ANN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "808-856-2102",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "WA",
            "license": "1060527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lahaina, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; 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.