Organization
THE ENDOSCOPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JODY A MONTELL (ADMINISTRATOR)
(808) 935-1956
Entity
Organization
Contact information
Practice address
134 PUUHONU WAY, HILO, HI 96720-2067
(808) 969-3973
(808) 935-7657
Mailing address
134 PUUHONU WAY, HILO, HI 96720-2067
(808) 935-7657
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
FSOF-9
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24549-8
HMSA
HI
05
—
55158201
—
HI
Enumeration date
11/15/2006
Last updated
08/22/2020
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