Provider Demographics
NPI:1861000796
Name:ALII SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:ALII SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-955-0255
Mailing Address - Street 1:1620 ALA MOANA BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-1437
Mailing Address - Country:US
Mailing Address - Phone:808-955-0255
Mailing Address - Fax:808-356-1958
Practice Address - Street 1:1620 ALA MOANA BLVD STE 500
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1437
Practice Address - Country:US
Practice Address - Phone:808-955-0255
Practice Address - Fax:808-356-1958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-16
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery