MEDICARE: BRONSEN K KAWEWEHI PHARM.D., M.B.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	18809	NV

General Provider Information

NPI Number	:	1285023127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRONSEN K KAWEWEHI PHARM.D., M.B.A.

Provider Business Mailing Address
First Line	:	5500 BOULDER HWY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89122-6010
Country	:	US
Telephone Number	:	702-435-7339
Fax Number	:	702-352-1082

Provider Business Practice Location Address
First Line	:	5500 BOULDER HWY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89122-6010
Country	:	US
Telephone Number	:	702-435-7339
Fax Number	:	702-352-1082

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2015
Last Update Date	:	01/15/2015

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