Provider Demographics
NPI:1962968248
Name:RP MEDICAL LLC
Entity type:Organization
Organization Name:RP MEDICAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PROUTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-667-6161
Mailing Address - Street 1:270 DAIRY RD STE 239
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2986
Mailing Address - Country:US
Mailing Address - Phone:808-661-6161
Mailing Address - Fax:
Practice Address - Street 1:305 KEAWE ST STE 507
Practice Address - Street 2:
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-2734
Practice Address - Country:US
Practice Address - Phone:808-667-6161
Practice Address - Fax:877-664-0133
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RP MEDICAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-12
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty