Provider Demographics
NPI:1356795199
Name:808 WELLNESS INC
Entity type:Organization
Organization Name:808 WELLNESS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHROEPFER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:808-875-4325
Mailing Address - Street 1:2439 S KIHEI RD
Mailing Address - Street 2:208B
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7283
Mailing Address - Country:US
Mailing Address - Phone:808-875-4325
Mailing Address - Fax:808-875-4325
Practice Address - Street 1:2439 S KIHEI RD
Practice Address - Street 2:208B
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7283
Practice Address - Country:US
Practice Address - Phone:808-875-4325
Practice Address - Fax:808-875-4325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-18
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI976171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty