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General NPI Number Information
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NPI Number | 1700928413
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Entity Type | Organization
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Legal Business Name | KAU COMMUNITY PHARMACY, INC.
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 96-1115 KAMANI STREET SUITE 36
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City | PAHALA
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State | HI
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Zip | 96777
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Country | US
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Telephone | 808-928-6252
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Fax | 808-928-6408
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Provider Business Mailing Address
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Address Line | PO BOX 299
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City | PAHALA
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State | HI
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Zip | 96777-0299
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Country | US
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Telephone | 808-928-6252
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Fax | 808-928-6408
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FLOYD W. BARTY
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Credential | D.M.D.
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Telephone | 808-732-8826
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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-585
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License Number State | HI
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