=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447046156
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HAZELINE REYES CABANG RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2025
-----------------------------------------------------
Last Update Date | 04/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 91-5480 KAPOLEI PKWY BLDG 5
-----------------------------------------------------
City | KAPOLEI
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96707-5016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-650-6457
-----------------------------------------------------
Fax | 808-622-7595
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 94-030 LEOLUA ST APT 202
-----------------------------------------------------
City | WAIPAHU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96797-1827
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
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-5130
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------