=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336746478
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROSS THOMAS FUJIMORI PASCUAL PHARMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2020
-----------------------------------------------------
Last Update Date | 10/01/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 750 KEEAUMOKU STREET
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-941-6719
-----------------------------------------------------
Fax | 808-941-6729
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1201 WILDER AVE APT 2904
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96822-3151
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-352-0387
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PH-3230
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------