Healthcare Provider Details

I. General information

NPI: 1518465384
Provider Name (Legal Business Name): CONNIE ZHOU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2018
Last Update Date: 01/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

377 KEAHOLE ST STE D11
HONOLULU HI
96825-3411
US

IV. Provider business mailing address

377 KEAHOLE ST STE D11
HONOLULU HI
96825-3411
US

V. Phone/Fax

Practice location:
  • Phone: 808-395-9491
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH-4222
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: