Provider Demographics
NPI:1306911888
Name:SPORTSMEDICINE HAWAII LTD
Entity type:Organization
Organization Name:SPORTSMEDICINE HAWAII LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:808-533-4545
Mailing Address - Street 1:PO BOX 1300
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96807-1300
Mailing Address - Country:US
Mailing Address - Phone:808-533-4545
Mailing Address - Fax:808-533-1656
Practice Address - Street 1:800 S BERETANIA ST STE 100
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5702
Practice Address - Country:US
Practice Address - Phone:808-533-4545
Practice Address - Fax:808-533-1656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH52082Medicare PIN