Provider Demographics
NPI:1518572445
Name:OHANA MEDICAL SUPPLY COMPANY LLC
Entity Type:Organization
Organization Name:OHANA MEDICAL SUPPLY COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-397-0385
Mailing Address - Street 1:4348 WAIALAE AVE # 223
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5767
Mailing Address - Country:US
Mailing Address - Phone:808-397-0385
Mailing Address - Fax:
Practice Address - Street 1:123 ALALA RD
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-3126
Practice Address - Country:US
Practice Address - Phone:808-397-0385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies