| Organization Name: | POIPU MD, LLC |
| NPI Number: | 1821467796 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | J BURRIS (PRESIDENT) |
| Mailing Address: | 5485 Koloa Rd Suite 1652 Koloa |
| State: | HI US |
| Postal Code: | 967563001 |
| Phone Number: | 8083463324 |
| Fax Number: | |
| NPI Enumeration Date: | 09/21/2015 |
| NPI Last Update Date: | 06/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | 14727 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | HI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |