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General NPI Number Information
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NPI Number | 1588759617
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Entity Type | Organization
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Legal Business Name | APOTHECARY OF KAUAI, INC.
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1177 KUHIO HWY SUITE 113
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City | KAPAA
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State | HI
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Zip | 96746-1113
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Country | US
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Telephone | 808-822-1447
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Fax | 808-823-0113
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Provider Business Mailing Address
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Address Line | PO BOX 1113
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City | KAPAA
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State | HI
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Zip | 96746-1113
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Country | US
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Telephone | 808-822-1447
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Fax | 808-823-0113
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MILES RICHARD LAHR
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Credential | RPH., CDE
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Telephone | 808-822-1447
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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 | PHY-344
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License Number State | HI
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