# ELAM SPORTS, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Elam Sports O'ahu, Elam Sports Oahu
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316982523
- **Authorized official:** CHANDRA L ELAM (COMPANY OFFICER)
- **Authorized official phone:** (808) 382-1372

## Contact information

- **Practice address:** 91-1027 SHANGRILA ST BLDG 1867, KAPOLEI, HI 96707-2101
- **Practice address phone:** (808) 674-9595
- **Practice address fax:** (808) 674-9696
- **Mailing address:** PO BOX 701119, KAPOLEI, HI 96709-1119
- **Mailing address phone:** (808) 674-9595
- **Mailing address fax:** (808) 674-9696

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 06/19/2006
- **Last updated:** 08/11/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00A0218931 | HMSA | HI |
| 05 | — | 50320201 | — | HI |