Healthcare Provider Details

I. General information

NPI: 1326031279
Provider Name (Legal Business Name): KUAKINI DEVELOPMENT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N KUAKINI ST
HONOLULU HI
96817-2364
US

IV. Provider business mailing address

321 N KUAKINI ST
HONOLULU HI
96817-2364
US

V. Phone/Fax

Practice location:
  • Phone: 808-547-9231
  • Fax: 808-547-9547
Mailing address:
  • Phone: 808-547-9231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number10097902
License Number StateHI

VIII. Authorized Official

Name: MR. GARY KAJIWARA
Title or Position: PRESIDENT & CEO
Credential:
Phone: 808-547-9231