Provider Demographics
NPI:1174888358
Name:PACIFIC ASSISTIVE TECHNOLOGIES
Entity type:Organization
Organization Name:PACIFIC ASSISTIVE TECHNOLOGIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEPOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-960-5233
Mailing Address - Street 1:1115 AINAOLA DR APT H
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3686
Mailing Address - Country:US
Mailing Address - Phone:808-960-5233
Mailing Address - Fax:
Practice Address - Street 1:1115 AINAOLA DR APT H
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3686
Practice Address - Country:US
Practice Address - Phone:808-960-5233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies