Healthcare Provider Details

I. General information

NPI: 1376209098
Provider Name (Legal Business Name): LOVE ALOHA EYECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2021
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75-1022 HENRY ST STE 2
KAILUA KONA HI
96740-3132
US

IV. Provider business mailing address

75-1022 HENRY ST STE 2
KAILUA KONA HI
96740-3132
US

V. Phone/Fax

Practice location:
  • Phone: 248-410-0115
  • Fax:
Mailing address:
  • Phone: 248-410-0115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLOTTE F LOVE
Title or Position: DOCTOR OF OPTOMETRY
Credential: OD
Phone: 248-410-0115