Provider Demographics
NPI:1407540149
Name:ALOHI CLINIC, LLC
Entity Type:Organization
Organization Name:ALOHI CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:COELHO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, AGCNS, APRN-RX
Authorized Official - Phone:808-582-8881
Mailing Address - Street 1:60 N BERETANIA ST APT 2003
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4759
Mailing Address - Country:US
Mailing Address - Phone:808-780-8147
Mailing Address - Fax:
Practice Address - Street 1:94-229 WAIPAHU DEPOT ST STE 308
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3033
Practice Address - Country:US
Practice Address - Phone:808-582-8881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-06
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI006216Medicaid