Healthcare Provider Details

I. General information

NPI: 1366609729
Provider Name (Legal Business Name): BRIAN T HIFUMI RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2875 KOAPAKA ST
HONOLULU HI
96819-1921
US

IV. Provider business mailing address

95-1002 HOLOLEA ST
MILILANI HI
96789-4983
US

V. Phone/Fax

Practice location:
  • Phone: 808-833-3414
  • Fax:
Mailing address:
  • Phone: 808-626-0968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH-1607
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: