Provider Demographics
NPI:1760745806
Name:ALOHA AIR SERVICES
Entity Type:Organization
Organization Name:ALOHA AIR SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CECIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SNODGRASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-770-3107
Mailing Address - Street 1:1409 2ND ST SE
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-3706
Mailing Address - Country:US
Mailing Address - Phone:253-770-3107
Mailing Address - Fax:253-864-0504
Practice Address - Street 1:210 N RAILROAD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-4371
Practice Address - Country:US
Practice Address - Phone:360-736-0928
Practice Address - Fax:360-736-0921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9051608Medicaid