Healthcare Provider Details

I. General information

NPI: 1336640770
Provider Name (Legal Business Name): DONNA S HOM PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2018
Last Update Date: 02/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3221 WAIALAE AVE
HONOLULU HI
96816-5842
US

IV. Provider business mailing address

3221 WAIALAE AVE
HONOLULU HI
96816-5842
US

V. Phone/Fax

Practice location:
  • Phone: 808-735-2811
  • Fax: 808-735-1794
Mailing address:
  • Phone: 808-735-2811
  • Fax: 808-735-1796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH964
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: