Provider Demographics
NPI:1255597514
Name:ROBERTO'S GROUP INC.
Entity type:Organization
Organization Name:ROBERTO'S GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-853-1688
Mailing Address - Street 1:819 MOOWAA ST
Mailing Address - Street 2:SUITE #114
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4431
Mailing Address - Country:US
Mailing Address - Phone:808-853-1688
Mailing Address - Fax:808-853-1690
Practice Address - Street 1:819 MOOWAA ST
Practice Address - Street 2:SUITE 114
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-4431
Practice Address - Country:US
Practice Address - Phone:808-853-1688
Practice Address - Fax:808-853-1690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-05
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI632837Medicaid
HI6621490001Medicare NSC