Provider Demographics
NPI:1083971774
Name:ALLIANCE TOXICOLOGY HAWAII LLC
Entity Type:Organization
Organization Name:ALLIANCE TOXICOLOGY HAWAII LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-496-6164
Mailing Address - Street 1:111 HEKILI ST
Mailing Address - Street 2:SUITE A-2302
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2800
Mailing Address - Country:US
Mailing Address - Phone:714-496-6164
Mailing Address - Fax:
Practice Address - Street 1:197 EMERALD BAY
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-1254
Practice Address - Country:US
Practice Address - Phone:714-496-6164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory