Provider Demographics
NPI:1376661520
Name:HOSANNA LLC
Entity Type:Organization
Organization Name:HOSANNA LLC
Other - Org Name:HAWAII FAMILY PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARTHURS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:808-323-3107
Mailing Address - Street 1:81-6587 MAMALAHOA HWY # C201
Mailing Address - Street 2:P O BOX 2060
Mailing Address - City:KEALAKEKUA
Mailing Address - State:HI
Mailing Address - Zip Code:96750-8133
Mailing Address - Country:US
Mailing Address - Phone:808-323-3107
Mailing Address - Fax:
Practice Address - Street 1:81-6587 MAMALAHOA HWY C201
Practice Address - Street 2:
Practice Address - City:KEALAKEKUA
Practice Address - State:HI
Practice Address - Zip Code:96750-8133
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:2007-03-27
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS959207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI100363Medicare ID - Type UnspecifiedMEDICARE GROUP