# KAILUA FAMILY PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ElixRx
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740684604
- **Authorized official:** JAKE BLECHTA (PRESIDENT)
- **Authorized official phone:** (808) 397-1336

## Contact information

- **Practice address:** 1090 KEOLU DR STE 112113, KAILUA, HI 96734-3871
- **Practice address phone:** (808) 260-9894
- **Practice address fax:** (808) 260-9957
- **Mailing address:** 1090 KEOLU DR, STE \#112/113, KAILUA, HI 96734-3871
- **Mailing address phone:** (808) 260-9894
- **Mailing address fax:** (808) 260-9957

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | PHY-856 | HI | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/21/2014
- **Last updated:** 02/08/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2148405 | PK | — |