1982035879 NPI number — NINETEEN FIFTY-ONE PARTNERS, INC.

Table of content: (NPI 1982035879)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982035879 NPI number — NINETEEN FIFTY-ONE PARTNERS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NINETEEN FIFTY-ONE PARTNERS, 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:
6
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:
1982035879
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 75
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KEALAKEKUA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96750-0075
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-324-6888
Provider Business Mailing Address Fax Number:
808-324-7888

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
74-5563 KUAKINI HWY
Provider Second Line Business Practice Location Address:
SUITE 129
Provider Business Practice Location Address City Name:
KAILUA-KONA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96740
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-324-6888
Provider Business Practice Location Address Fax Number:
808-324-7888
Provider Enumeration Date:
12/03/2013

Additional Information

Authorized Official

Authorized Official Last Name:
MANWARRING
Authorized Official First Name:
TARA
Authorized Official Middle Name:
LEI
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
808-324-6888

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  PHY845 , 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: 2143211 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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