Healthcare Provider Details

I. General information

NPI: 1316859622
Provider Name (Legal Business Name): UNIVERSITY CLINICAL EDUCATION & RESEARCH ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 ILALO ST
HONOLULU HI
96813-5515
US

IV. Provider business mailing address

701 ILALO ST
HONOLULU HI
96813-5515
US

V. Phone/Fax

Practice location:
  • Phone: 808-909-8704
  • Fax:
Mailing address:
  • Phone: 808-909-8704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY CORREA
Title or Position: PROVIDER ENROLLMENT REPRESENTATIVE
Credential:
Phone: 808-469-4932