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NPI Code Detail

MEDICARE: DEXTER A WONG RPH

MEDICARE: DEXTER A WONG RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist1183HI

General Provider Information

NPI Number : 1417563990
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEXTER A WONG RPH
Provider Business Mailing Address
First Line : 1131 KUALA ST
Second Line :
City : PEARL CITY
State : HI
Zip : 96782-2886
Country : US
Telephone Number : 808-454-8792
Fax Number : 808-454-8794
Provider Business Practice Location Address
First Line : 1131 KUALA ST
Second Line :
City : PEARL CITY
State : HI
Zip : 96782-2886
Country : US
Telephone Number : 808-454-8792
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2020
Last Update Date : 09/19/2020

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Directions to “ DEXTER A WONG RPH” Practice Location

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