Provider Demographics
NPI:1134237829
Name:UNIV HAWAII HYPERBARIC TXT CTR
Entity type:Organization
Organization Name:UNIV HAWAII HYPERBARIC TXT CTR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR HYPERBARIC TXT CTR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:P
Authorized Official - Last Name:FARM
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:808-587-3425
Mailing Address - Street 1:347 N KUAKINI STREET
Mailing Address - Street 2:UNIV HAWAII HYPERBARIC TREATMENT CENTER
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817
Mailing Address - Country:US
Mailing Address - Phone:808-587-3425
Mailing Address - Fax:808-587-3430
Practice Address - Street 1:347 N KUAKINI STREET
Practice Address - Street 2:UNIV HAWAII HYPERBARIC TREATMENT CENTER
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817
Practice Address - Country:US
Practice Address - Phone:808-587-3425
Practice Address - Fax:808-587-3430
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIV HAWAII
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-25
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA0013241OtherHMSA A BCBS LICENSEE
HI52856501Medicaid
HI52856501Medicaid