Healthcare Provider Details

I. General information

NPI: 1114017621
Provider Name (Legal Business Name): KERRI C OKAMURA R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 E PUAINAKO ST
HILO HI
96720-5242
US

IV. Provider business mailing address

344 KIPUNI ST
HILO HI
96720-6049
US

V. Phone/Fax

Practice location:
  • Phone: 808-959-4575
  • Fax: 808-981-0385
Mailing address:
  • Phone: 808-959-4575
  • Fax: 808-981-0385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH1731
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: