Provider Demographics
NPI:1699720615
Name:P.T. HAWAII, INC
Entity type:Organization
Organization Name:P.T. HAWAII, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:GROVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-227-4900
Mailing Address - Street 1:91-2135 FORT WEAVER ROAD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-1929
Mailing Address - Country:US
Mailing Address - Phone:808-676-5331
Mailing Address - Fax:808-671-2931
Practice Address - Street 1:94-801 FARRINGTON HWY
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3164
Practice Address - Country:US
Practice Address - Phone:808-680-9123
Practice Address - Fax:808-680-9889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT2585225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI6397309OtherUNITED HEALTH ALLIANCE
HI579641Medicaid
HI=========OtherHMAA
HI579641Medicaid
HI=========OtherALOHACARE