Healthcare Provider Details

I. General information

NPI: 1730856261
Provider Name (Legal Business Name): SARAH TATSUMOTO PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 08/24/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLDG 676 RM 104 USAHC - SCHOFIELD BARRACKS
SCHOFIELD HI
96857-5460
US

IV. Provider business mailing address

46-252 KALALI ST
KANEOHE HI
96744-4157
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-8423
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH-1425
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: