Provider Demographics
NPI:1790998185
Name:ALOHA HOME HEALTH CARE
Entity Type:Organization
Organization Name:ALOHA HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:TOBIAS
Authorized Official - Last Name:DIZON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-677-2298
Mailing Address - Street 1:94-547 UKEE ST.
Mailing Address - Street 2:STE #117
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797
Mailing Address - Country:US
Mailing Address - Phone:808-677-2298
Mailing Address - Fax:808-676-8734
Practice Address - Street 1:94-547 UKEE ST.
Practice Address - Street 2:STE #117
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797
Practice Address - Country:US
Practice Address - Phone:808-677-2298
Practice Address - Fax:808-676-8734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10508976332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI032482-02Medicare UPIN