Organization
BIG ISLAND OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK TAKEO HIRONAGA LICENSE OPTICIAN (PRESIDENT)
(808) 935-1360
Entity
Organization
Contact information
Practice address
64-1032 MAMALAHOA HWY, UNIT 1A, KAMUELA, HI 96743
(808) 887-1973
(808) 881-8578
Mailing address
64-1032 MAMALAHOA HWY, UNIT 1A, KAMUELA, HI 96743
(808) 887-1973
(808) 881-8578
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08402801
—
HI
Enumeration date
08/22/2007
Last updated
08/22/2007
Update your record
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