Organization Active NPI

Pacific Eyewear Inc

  • Eyewear Supplier
  • Lihue, HI
National Provider Identifier
1629280284
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
PACIFIC EYEWEAR INC
Practice address
4418 Kukui Grove St
Lihue, HI 96766-1676
Phone
(808) 245-5377
Fax
(808) 245-6142
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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

Authorized official

Name
Dr. Larry Sherrer, M.D.
Title
Owner
Phone
(808) 245-5377

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

4418 Kukui Grove St
Lihue, HI 96766-1676

Mailing address

4418 Kukui Grove St
Lihue, HI 96766-1676
Phone (808) 245-5377

Other identifiers 1

IdentifierTypeStateIssuer
055164-01MedicaidHI

National Provider Directory

National Provider Directory

Locations

4418 Kukui Grove St
Lihue, HI 96766
Phone (808) 245-5377

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1629280284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4418 KUKUI GROVE ST",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967661676",
            "telephone_number": "808-245-5377",
            "fax_number": "808-245-6142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4418 KUKUI GROVE ST",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967661676",
            "telephone_number": "808-245-5377",
            "fax_number": "808-245-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC EYEWEAR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "SHERRER",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-245-5377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055164-01",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lihue, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.