Provider Demographics
NPI:1912510371
Name:LOKAHI NUTRITION LLC
Entity type:Organization
Organization Name:LOKAHI NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BASAK
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD
Authorized Official - Phone:813-815-0901
Mailing Address - Street 1:24829 VINTAGE CT
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-7401
Mailing Address - Country:US
Mailing Address - Phone:813-815-0901
Mailing Address - Fax:
Practice Address - Street 1:24829 VINTAGE CT
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-7401
Practice Address - Country:US
Practice Address - Phone:813-815-0901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-26
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty