Healthcare Provider Details

I. General information

NPI: 1144284340
Provider Name (Legal Business Name): MOLOKAI DRUGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 01/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 KAMOI ST STE 100
KAUNAKAKAI HI
96748
US

IV. Provider business mailing address

PO BOX 558
KAUNAKAKAI HI
96748-0558
US

V. Phone/Fax

Practice location:
  • Phone: 808-553-5790
  • Fax: 808-553-5308
Mailing address:
  • Phone: 808-553-5790
  • Fax: 808-553-5308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY205
License Number StateHI

VIII. Authorized Official

Name: DAVID MIKAMI
Title or Position: CEO CHAIRMAN
Credential: RPH
Phone: 808-553-5790