# INTELERETINA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669989117
- **Authorized official:** ERIC HANNUM (PRESIDENT)
- **Authorized official phone:** (808) 277-6816

## Contact information

- **Practice address:** 1010 S KING ST STE 222, HONOLULU, HI 96814-1701
- **Practice address phone:** (808) 277-6816
- **Mailing address:** PO BOX 31000 MAIL CODE 5769, HONOLULU, HI 96849-5769

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 293D00000X | Physiological Laboratory | — | NULL | Yes |

## Other

- **Enumeration date:** 01/05/2018
- **Last updated:** 01/05/2018