Provider Demographics
NPI:1790356632
Name:A DASH OF NUTRITION LLC
Entity Type:Organization
Organization Name:A DASH OF NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DASHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CORPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-366-8836
Mailing Address - Street 1:38 S JUDD ST APT 14A
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2600
Mailing Address - Country:US
Mailing Address - Phone:808-366-8836
Mailing Address - Fax:
Practice Address - Street 1:38 S JUDD ST APT 14A
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2600
Practice Address - Country:US
Practice Address - Phone:808-366-8836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service