Provider Demographics
NPI:1164931085
Name:EMMAUS ROAD LLC
Entity Type:Organization
Organization Name:EMMAUS ROAD LLC
Other - Org Name:HAWAII HEALTH AND WEIGHT LOSS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ARTHURS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:808-323-3107
Mailing Address - Street 1:75-5870 WALUA RD. #200
Mailing Address - Street 2:
Mailing Address - City:KAILUA-KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740
Mailing Address - Country:US
Mailing Address - Phone:808-323-3107
Mailing Address - Fax:808-323-0012
Practice Address - Street 1:75-5870 WALUA RD
Practice Address - Street 2:
Practice Address - City:KAILUA-KONA
Practice Address - State:HI
Practice Address - Zip Code:96740
Practice Address - Country:US
Practice Address - Phone:808-323-3107
Practice Address - Fax:808-323-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-22
Last Update Date:2017-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty