| NPI | 1609605518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMI HATTORI Office Manager/Billing Specialist 808-777-4176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2024-07-29 |
| Last Update Date | 2024-07-29 |