Independent Living Equipment and Pacmed
Organization Active NPI Durable Medical Equipment & Medical Supplies · Honolulu, HI
NPI 1811971872 · NPPES record last updated Jun 24, 2019
Key facts
- NPI
- 1811971872
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- License
- 10575079 (HI)
- Legal business name
- INDEPENDENT LIVING EQUIPMENT AND PACMED
- Practice address
- 80 Sand Island Access Rd Ste 238
Honolulu, HI 96819-4912 - Phone
- (808) 537-1671
- Fax
- (808) 791-6990
- NPI assigned
- Dec 2, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Keith Matsunaga, MSME, ATP
- Title
- President
- Phone
- (808) 537-1671
Corporate family (same tax ID) 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930066027 | HI | DME Supplier - Medical Supply Company |
6305967019 | Practice locations: Honolulu, HI |
National Provider Directory
- Tax ID family
- Independent Living Equipment and Pacmed
Locations
420 Kuwili St
Ste 101
Honolulu, HI 96817
Phone (808) 537-1671
80 Sand Island Access Rd
Ste 238
Honolulu, HI 96819
Phone (808) 392-9238
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 10575079 | HI | Yes |
Addresses
Primary practice location
80 Sand Island Access Rd Ste 238
Honolulu, HI 96819-4912
Mailing address
80 Sand Island Access Rd Ste 238
Honolulu, HI 96819-4912
Phone (808) 537-1671
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A210094 | Other | HI | HMSA PROVIDER ID |
| 539455 | Medicaid | HI |
Other names
- PACMED
Other providers in Honolulu, HI
- Gary S. Inamine
- Nikki Inamine
- Inclusive ABA Hi LLC
- Incontrol Diabetes Center, LLC
- Independent Living Equipment and Pacmed
- Independent Physical Therapy LLC
- Individual and Relationship Counseling Center, LLC
- Individual Movement Improvement LLC
- Kelly Ann Rabang Ines
- Infectious Disease Consultants of Hawaii LLC
All providers in Honolulu, HI · Durable Medical Equipment & Medical Supplies in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.