1669674529 NPI number — EGRET INC.

Table of content: (NPI 1669674529)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669674529 NPI number — EGRET INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EGRET INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BELTONE HEARING AID CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669674529
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3221 WAIALAE AVE
Provider Second Line Business Mailing Address:
SUITE 345
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96816-5842
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-732-5223
Provider Business Mailing Address Fax Number:
808-735-9598

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
444 HANA HWY
Provider Second Line Business Practice Location Address:
SUITE. 209
Provider Business Practice Location Address City Name:
KAHULUI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96732-2315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-871-9020
Provider Business Practice Location Address Fax Number:
808-871-9024
Provider Enumeration Date:
06/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WEBB
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
KEVIN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
808-732-5223

Provider Taxonomy Codes

  • Taxonomy code: 237700000X , with the licence number:  58 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: B09296-1 . This is a "HMSA MAUI OFFICE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




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