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Organization
IAOMAI 4 LLC
Active
Organization
IAOMAI 4 LLC
Active
Other names
Lifeway Pharmacy (Koloa)
Organization subpart
No
Provider details
NPI number
Authorized official
LIANNE HIROKO MALAPIT PHARM. D. (MEMBER/OWNER)
(808) 639-1891
Entity
Organization
Contact information
Practice address
5330 KOLOA RD STE 2, KOLOA, HI 96756-8624
(808) 742-7512
(808) 742-7070
Mailing address
PO BOX 3753, LIHUE, HI 96766-6753
(808) 639-1891
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PHY-806
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
688294
—
HI
01
—
PHY-806
PHARMACY LICENSE
HI
Enumeration date
08/02/2018
Last updated
08/02/2018
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