| NPI | 1780639724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUTHANA TEPRASEUTH Pharmacist In Charge 808-432-5702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0003X Pharmacy Managed Care Organization Pharmacy (Licence: HI PHY-671) |
| Additional Taxonomies | 3336C0002X Pharmacy Clinic Pharmacy |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2017-06-09 |