=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649726837
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALAHNUI HEALTH SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/29/2016
-----------------------------------------------------
Last Update Date | 08/29/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9000 W KAUL AVE
-----------------------------------------------------
City | MILWAUKEE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53225-2018
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-241-5245
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9000 W KAUL AVE
-----------------------------------------------------
City | MILWAUKEE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53225-2018
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-241-5245
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | BINYOTI FELIX AMUNGWAFOR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 414-241-5245
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 305S00000X
-----------------------------------------------------
Taxonomy Name | Point of Service
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------