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General NPI Number Information
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NPI Number | 1801593066
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Entity Type | Organization
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Legal Business Name | KAUAI PROFESSIONAL PHARMACY LLC
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Dates
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Enumeration Date | 02/08/2023
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Last Update Date | 02/16/2023
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Provider Practice Location Address
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Address Line | 3-3420B KUHIO HWY STE 101
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City | LIHUE
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State | HI
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Zip | 96766-1042
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Country | US
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Telephone | 808-245-6306
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Fax |
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Provider Business Mailing Address
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Address Line | 5904 WAIPOULI RD
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City | KAPAA
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State | HI
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Zip | 96746-8822
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Country | US
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Telephone | 808-635-5524
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JEFFREY JAMES CHOMIUK
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Credential | RPH
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Telephone | 808-245-6306
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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 |
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License Number State |
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