Provider Demographics
NPI:1972058162
Name:CRSCP MAUI INC
Entity type:Organization
Organization Name:CRSCP MAUI INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:OLKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-735-1935
Mailing Address - Street 1:650 IWILEI RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-5086
Mailing Address - Country:US
Mailing Address - Phone:808-735-1935
Mailing Address - Fax:808-735-6875
Practice Address - Street 1:33 LONO AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1633
Practice Address - Country:US
Practice Address - Phone:808-871-1411
Practice Address - Fax:808-871-1441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-17
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty