Healthcare Provider Details

I. General information

NPI: 1982757530
Provider Name (Legal Business Name): JILL E.O. KOZUKI PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45-602 KAMEHAMEHA HWY
KANEOHE HI
96744-2017
US

IV. Provider business mailing address

1090 ALA NAPUNANI ST APT. 319
HONOLULU HI
96818-1788
US

V. Phone/Fax

Practice location:
  • Phone: 808-432-3815
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH-1454
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 44541
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: