| NPI | 1740407840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT SANDSTROM Pharmacist In Charge 808-934-4090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0003X Pharmacy Managed Care Organization Pharmacy (Licence: HI PHY563) |
| Additional Taxonomies | 3336C0002X Pharmacy Clinic Pharmacy |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2017-02-28 |