Provider Demographics
NPI:1083016398
Name:MAKA LAB SERVICES COMPANY LLC
Entity Type:Organization
Organization Name:MAKA LAB SERVICES COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SIBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-955-0255
Mailing Address - Street 1:1620 ALA MOANA BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-1437
Mailing Address - Country:US
Mailing Address - Phone:808-955-0255
Mailing Address - Fax:
Practice Address - Street 1:1620 ALA MOANA BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1437
Practice Address - Country:US
Practice Address - Phone:808-955-0255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RETINA INSTITUTE MANAGEMENT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156F00000XEye and Vision Services ProvidersTechnician/TechnologistGroup - Single Specialty