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Organization
WAILEA PHARMACY LLC
Active
Organization
WAILEA PHARMACY LLC
Active
Other names
Wailea Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
FARAH MIKHAIL (MEMBER)
(808) 927-3426
Entity
Organization
Contact information
Practice address
34 WAILEA GATEWAY PL STE A103, WAILEA, HI 96753-6525
(808) 879-0123
(808) 879-2345
Mailing address
34 WAILEA GATEWAY PL # A103, WAILEA, HI 96753-6525
(808) 879-0123
(808) 879-2345
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY-855
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2147004
PK
—
Enumeration date
07/21/2014
Last updated
01/19/2016
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