Healthcare Provider Details

I. General information

NPI: 1568748150
Provider Name (Legal Business Name): MICHEL W HANNA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2011
Last Update Date: 10/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92-1141 PANANA ST APT 1402
KAPOLEI HI
96707-3741
US

IV. Provider business mailing address

92-1141 PANANA ST APT 1402
KAPOLEI HI
96707-3741
US

V. Phone/Fax

Practice location:
  • Phone: 808-391-4522
  • Fax: 808-488-7505
Mailing address:
  • Phone: 808-391-4522
  • Fax: 808-488-7505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2545
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: