Healthcare Provider Details

I. General information

NPI: 1750918736
Provider Name (Legal Business Name): KAUMANA PHARMACEUTICALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 03/27/2020
Certification Date: 03/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1964 UHALOA RD
HILO HI
96720-1431
US

IV. Provider business mailing address

1964 UHALOA RD
HILO HI
96720-1431
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State

VIII. Authorized Official

Name: PHILLIP GIACOBBI
Title or Position: CEO
Credential: PHARM.D.
Phone: 808-345-4516