Healthcare Provider Details

I. General information

NPI: 1114985611
Provider Name (Legal Business Name): ALOHA SURGICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 12/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 HOOHANA ST
KAHULUI HI
96732-2452
US

IV. Provider business mailing address

239 HOOHANA ST
KAHULUI HI
96732-2452
US

V. Phone/Fax

Practice location:
  • Phone: 808-893-0578
  • Fax:
Mailing address:
  • Phone: 808-893-0578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberFSOF-11
License Number StateHI

VIII. Authorized Official

Name: RICHARD L SHARFF JR.
Title or Position: VP
Credential:
Phone: 205-545-2572