Provider Demographics
NPI:1285141283
Name:AL'S VINYL REPAIR INC.
Entity type:Organization
Organization Name:AL'S VINYL REPAIR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BC-HIS
Authorized Official - Prefix:
Authorized Official - First Name:CARLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-732-5223
Mailing Address - Street 1:3221 WAIALAE AVE STE 345
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5800
Mailing Address - Country:US
Mailing Address - Phone:808-732-5223
Mailing Address - Fax:
Practice Address - Street 1:98-450 KAMEHAMEHA HWY
Practice Address - Street 2:#4
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782
Practice Address - Country:US
Practice Address - Phone:808-488-9987
Practice Address - Fax:808-488-6342
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AL'S VINYL REPAIR INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDME-0141332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment