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General NPI Number Information
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NPI Number | 1134566250
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Entity Type | Organization
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Legal Business Name | FOOD PANTRY, LTD
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Dates
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Enumeration Date | 05/30/2013
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Last Update Date | 05/30/2013
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Provider Practice Location Address
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Address Line | 5095 NAPILIHAU ST
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City | LAHAINA
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State | HI
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Zip | 96761-8800
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Country | US
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Telephone | 808-669-1600
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Fax | 808-669-2522
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Provider Business Mailing Address
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Address Line | 3536 HARDING AVE
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City | HONOLULU
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State | HI
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Zip | 96816-2453
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Country | US
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Telephone | 808-735-7202
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | PATRICK ADAMS
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Credential |
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Telephone | 808-735-7202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY837
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License Number State | HI
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