Provider Demographics
NPI:1942391222
Name:SPINE CARE HAWAII INC.
Entity type:Organization
Organization Name:SPINE CARE HAWAII INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:THURLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DABCO
Authorized Official - Phone:808-261-4040
Mailing Address - Street 1:407 ULUNIU ST
Mailing Address - Street 2:SUITE 311
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2519
Mailing Address - Country:US
Mailing Address - Phone:808-261-4040
Mailing Address - Fax:
Practice Address - Street 1:407 ULUNIU ST
Practice Address - Street 2:SUITE 311
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2519
Practice Address - Country:US
Practice Address - Phone:808-261-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI794111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI000022068-1OtherHMSA
HI57444Medicare ID - Type UnspecifiedSPINE CARE HAWAII INC.
HIU79029Medicare UPIN
HI57446Medicare ID - Type UnspecifiedDR. PAUL THURLOW