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Organization

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Organization subpart
No

Provider details

NPI number
Authorized official
MR. PETER E ACKMAN LDO (OWNER OPTICIAN)
(808) 528-5252
Entity
Organization

Contact information

Practice address
1110 UNIVERSITY AVE, SUITE 311, HONOLULU, HI 96826-1540
(808) 528-5252
(808) 528-0580
Mailing address
1110 UNIVERSITY AVE, SUITE 311, HONOLULU, HI 96826-1540
(808) 528-5252
(808) 528-0580

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
159
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A1861-2
BLUE CROSS BLUE SHIELD
HI
Enumeration date
02/28/2007
Last updated
09/09/2014
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