Healthcare Provider Details

I. General information

NPI: 1780202069
Provider Name (Legal Business Name): HOLLY S MORITA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOLLY S LUND

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4454 NUHOU ST
LIHUE HI
96766-8018
US

IV. Provider business mailing address

4454 NUHOU ST
LIHUE HI
96766-8018
US

V. Phone/Fax

Practice location:
  • Phone: 808-246-0290
  • Fax:
Mailing address:
  • Phone: 808-246-0290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number75736
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH-4464
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS024648
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: