MEDICARE: MR. BRIAN T HIFUMI RPH

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	PH-1607	HI

General Provider Information

NPI Number	:	1366609729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRIAN T HIFUMI RPH

Provider Business Mailing Address
First Line	:	95-1002 HOLOLEA ST
Second Line	:
City	:	MILILANI
State	:	HI
Zip	:	96789-4983
Country	:	US
Telephone Number	:	808-626-0968
Fax Number	:

Provider Business Practice Location Address
First Line	:	2875 KOAPAKA ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96819-1921
Country	:	US
Telephone Number	:	808-833-3414
Fax Number	:

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

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	05/21/2008

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