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NPI Code Detail

MEDICARE: SARA MITSUE LUM PHARMD

MEDICARE: SARA MITSUE LUM PHARMD
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
1183500000XPharmacistPH-3735HI

General Provider Information

NPI Number : 1417450164
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA MITSUE LUM PHARMD
Provider Business Mailing Address
First Line : 5156 KALANIANAOLE HWY
Second Line :
City : HONOLULU
State : HI
Zip : 96821-1507
Country : US
Telephone Number : 808-377-9643
Fax Number :
Provider Business Practice Location Address
First Line : 5156 KALANIANAOLE HWY
Second Line :
City : HONOLULU
State : HI
Zip : 96821-1507
Country : US
Telephone Number : 808-377-9643
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2018
Last Update Date : 03/08/2018

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Directions to “ SARA MITSUE LUM PHARMD” Practice Location

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