Provider Demographics
NPI:1194263558
Name:ALOHAENT, LLC
Entity type:Organization
Organization Name:ALOHAENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTED ENTITY
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:STOVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-960-5412
Mailing Address - Street 1:64-1035 MAMALAHOA HWY STE K
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-8440
Mailing Address - Country:US
Mailing Address - Phone:808-887-0706
Mailing Address - Fax:808-887-1878
Practice Address - Street 1:64-1035 MAMALAHOA HWY STE K
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8440
Practice Address - Country:US
Practice Address - Phone:808-887-0706
Practice Address - Fax:808-887-1878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 18946207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty