=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851443121
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVEN BORENSTEIN R.PH.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 910 WAINEE ST
-----------------------------------------------------
City | LAHAINA
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96761-1622
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-662-6945
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3785 LOWER HONOAPIILANI RD APT 108
-----------------------------------------------------
City | LAHAINA
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96761-9321
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-669-7902
-----------------------------------------------------
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-1286
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 30075
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------