Provider Demographics
NPI:1780127225
Name:LINDEN FAMILY MEDICINE CLINIC LLC
Entity type:Organization
Organization Name:LINDEN FAMILY MEDICINE CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ROSEMARY
Authorized Official - Last Name:LINDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-961-0146
Mailing Address - Street 1:400 HUALANI ST
Mailing Address - Street 2:STE 196
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4378
Mailing Address - Country:US
Mailing Address - Phone:808-961-0146
Mailing Address - Fax:808-969-3378
Practice Address - Street 1:400 HUALANI ST
Practice Address - Street 2:STE 196
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4378
Practice Address - Country:US
Practice Address - Phone:808-961-0146
Practice Address - Fax:808-969-3378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-01
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty