Healthcare Provider Details

I. General information

NPI: 1912813478
Provider Name (Legal Business Name): AMY LUM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST
HONOLULU HI
96826-1028
US

IV. Provider business mailing address

1319 PUNAHOU ST
HONOLULU HI
96826-1028
US

V. Phone/Fax

Practice location:
  • Phone: 808-983-8399
  • Fax:
Mailing address:
  • Phone: 808-983-8399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2166
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: