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General NPI Number Information
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NPI Number | 1235475138
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Entity Type | Organization
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Legal Business Name | LEEWARD DRUG LIMITED DBA WAIPAHU DRUG EXPRESS
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Dates
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Enumeration Date | 12/20/2012
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Last Update Date | 12/20/2012
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Provider Practice Location Address
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Address Line | 94-837 WAIPAHU ST. 2ND FLOOR
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City | WAIPAHU
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State | HI
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Zip | 96797
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Country | US
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Telephone | 808-677-9611
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Fax | 808-671-5961
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Provider Business Mailing Address
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Address Line | 94-748 HIKIMOE ST STE A
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City | WAIPAHU
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State | HI
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Zip | 96797-3350
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Country | US
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Telephone | 808-677-0794
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Fax | 808-677-1199
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Authorized Official
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Title or Position | PRESIDENT
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Name | TERRENCE YOUNG
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Credential |
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Telephone | 808-677-0794
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 822
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License Number State | HI
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