Organization
TEAM MAKENA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERNESTINA SMITH (COMPLIANCE OFFICER)
(949) 382-3919
Entity
Organization
Contact information
Practice address
500 ALA MOANA BLVD STE 400, HONOLULU, HI 96813-4920
(949) 474-1753
(949) 251-5120
Mailing address
27051 TOWNE CENTRE DR STE 180, FOOTHILL RANCH, CA 92610-2819
(800) 996-4001
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
10/19/2017
Last updated
03/15/2018
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