Organization
HAWAII ENDOSCOPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT B HALLIDAY (MEMBER OF OWNER)
(800) 362-9772
Entity
Organization
Contact information
Practice address
2226 LILIHA STREET, SUITE 407, HONOLULU, HI 96817
(808) 531-5823
(808) 531-5819
Mailing address
PO BOX 29960, HONOLULU, HI 96820
(800) 362-9772
(425) 637-4646
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000232165
MEDICAID HMSA QUEST
—
01
—
52073501
MEDICARE CLASS
—
05
—
52073501
—
HI
01
—
54102
MEDICARE CLASS
—
01
—
Z1617
MDX
HI
01
—
Z1617
QUEENS MDS
—
Enumeration date
04/24/2006
Last updated
08/22/2020
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