| Evolve Medical Center, Llc | |
|
75-5722 Kuakini Hwy Ste 103 Kailua Kona HI 96740-1721 | |
| (808) 444-3477 | |
| (808) 444-3478 |
| Full Name | Evolve Medical Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 75-5722 Kuakini Hwy Ste 103, Kailua Kona, Hawaii |
| Authorized Official Name and Position | Shannon Price-schwartz (OWNER) |
| Authorized Official Contact | 8089374961 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Medical Center, Llc 75-5722 Kuakini Hwy Ste 103 Kailua Kona HI 96740-1721 Ph: () - | Evolve Medical Center, Llc 75-5722 Kuakini Hwy Ste 103 Kailua Kona HI 96740-1721 Ph: (808) 444-3477 |
| NPI Number | 1366019143 |
|---|---|
| Provider Enumeration Date | 06/09/2021 |
| Last Update Date | 11/07/2022 |
| Medicare PECOS PAC ID | 8426459447 |
|---|---|
| Medicare Enrollment ID | O20210629000868 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366019143 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Shannon M Price-schwartz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841566064 PECOS PAC ID: 1557517109 Enrollment ID: I20140505002024 |
| Provider Name | Kelly M Marshall |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295094662 PECOS PAC ID: 3779809728 Enrollment ID: I20150310001123 |
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