1588097943 NPI number — RICHARD M SWORD PHD INC

Table of content: (NPI 1588097943)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588097943 NPI number — RICHARD M SWORD PHD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICHARD M SWORD PHD 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:
Provider Other Organization Name Type Code:
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:
1588097943
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30 AHUWALE PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAKAWAO
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96768-8860
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-573-0800
Provider Business Mailing Address Fax Number:
808-573-0802

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 AHUWALE PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAKAWAO
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96768-8860
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-573-0800
Provider Business Practice Location Address Fax Number:
808-573-0802
Provider Enumeration Date:
08/20/2013

Additional Information

Authorized Official

Authorized Official Last Name:
FERNANDEZ
Authorized Official First Name:
KATHLEEN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
808-573-0800

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PSY 262 , 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: 990232395 . This is a "HMAA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: B 1217 . This is a "HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 01163701/ 584880 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".
  • Identifier: R 17876 . This is a "UPIN" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 220800 . This is a "HMA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com