MEDICARE: PHARM NEUT INC

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
1	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0001203859	OTHER		RX AMERICA
2	120385	OTHER		WALGREENS HEALTH INITIATI
3	1203859	OTHER		CAREMARK NABP
4	1203859	OTHER		AETNA NABP
5	1203859	OTHER		EXPRESS SCRIPTS NABP
6	1203859	OTHER		MEMBER HEALTH INC NABP
7	1203859	OTHER		WELL POINT NABP
8	00223933	OTHER	HI	HMSA
9	12038	OTHER		PRESCRIPTION SOLUTIONS NA
10	1203859	OTHER		WEB MD NABP
11	1203859	OTHER		ARGUS NABP
12	1203859	OTHER		RESTAT NABP
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609945187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARM NEUT INC

Provider Business Mailing Address
First Line	:	850 W HIND DR
Second Line	:	#111
City	:	HONOLULU
State	:	HI
Zip	:	96821-1845
Country	:	US
Telephone Number	:	808-373-5151
Fax Number	:	808-373-5196

Provider Business Practice Location Address
First Line	:	850 W HIND DR
Second Line	:	#111
City	:	HONOLULU
State	:	HI
Zip	:	96821-1845
Country	:	US
Telephone Number	:	808-373-5151
Fax Number	:	808-373-5196

Authorized Official
Title or Position	:	CORP PRES V PRES
Name	:	MRS. BONNIE G PREBULA
Credential	:
Telephone Number	:	808-373-5151

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	08/22/2020

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Directions to “PHARM NEUT INC ” Practice Location

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