Provider Demographics
NPI:1972607976
Name:GAMMIE HOME CARE INC
Entity type:Organization
Organization Name:GAMMIE HOME CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIMABUKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-877-4063
Mailing Address - Street 1:292 ALAMAHA ST
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2418
Mailing Address - Country:US
Mailing Address - Phone:808-877-4032
Mailing Address - Fax:808-877-3359
Practice Address - Street 1:292 ALAMAHA ST
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2418
Practice Address - Country:US
Practice Address - Phone:808-877-4032
Practice Address - Fax:808-877-3359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI02311001Medicaid
HI0372280001Medicare NSC
HI0372280002Medicare NSC