Integrated Provider Services LLC
Preferred Provider Organization in Honolulu, HI. Organization (NPI-2).
NPI number1720971773
StatusActive
Last updated in NPPESMay 21, 2026
Details
- NPI
- 1720971773
- Entity type
- Organization (NPI-2)
- Legal business name
- Integrated Provider Services LLC
- Organization subpart
- No
- Enumeration date
- May 29, 2025
- Certification date
- May 21, 2026
- Last updated
- May 21, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305R00000X | Preferred Provider Organization | – | – | Yes |
Practice location
1122 Kumukumu St Apt EHonolulu, HI 96825-2618
Phone 808-798-9979
Mailing address
Po Box 26043Honolulu, HI 96825-6043
Phone 808-798-9979
Authorized official
Jessica Dawson
Owner, Manager
8087989979
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