Market Street Clinic, Inc.

LBN: Market Street Clinic, Inc.
Market Street Clinic, Inc. is an health care organization with primary practice located at 53A N Market St , Wailuku HI 96793-1719. The organization recently has only one registered license in Managed Care Organizations / Health Maintenance Organization, which is considered as the primary health care specialty. Market Street Clinic, Inc. can be contacted via phone (808) 244-0007, or through Boulange, Chris Alan via phone (808) 244-0007.

Contact Information

Primary practice address
53A N Market St Wailuku HI 96793-1719
Phone: (808) 244-0007
Fax: (808) 244-8011
Website:
Map and Directions
Authorized official contact:
Name: Boulange, Chris Alan Doctor of Medicine (MD)
Phone: (808) 244-0007

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Health Maintenance Organization 302R00000X MD-2877 Hawaii

Profile Details

NPI number 1275798928
LBN Legal business name Market Street Clinic, Inc.
DBA Doing business as
Authorized official Boulange, Chris Alan Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 22nd, 2008
Last updated Jul 22nd, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275798928 NPPES
Hawaii Other A21446-8 HMSA
Hawaii MEDICAID 08781201 HMSA

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