Healthcare Provider Details

I. General information

NPI: 1598362048
Provider Name (Legal Business Name): CIARA BUTTS PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 10/07/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1964 UHALOA RD
HILO HI
96720-1431
US

IV. Provider business mailing address

PO BOX 403
HONOMU HI
96728-0403
US

V. Phone/Fax

Practice location:
  • Phone: 808-345-4516
  • Fax:
Mailing address:
  • Phone: 808-333-7032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4419
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: