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Organization

QUEENS DEVELOPMENT CORPORATION & SUBSIDIARIES

Active
Other names
QUEENS POB III PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
GAVIN SANJUME PHARMD (DIR, RETAIL & CONTRCT PHCY)
(808) 691-4342
Entity
Organization

Contact information

Practice address
550 S BERETANIA ST, STE 102, HONOLULU, HI 96813-2414
(808) 691-8925
(808) 691-8926
Mailing address
550 S BERETANIA ST, STE 102, HONOLULU, HI 96813-2414
(808) 691-8925
(808) 691-8926

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY679
HI
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2019448
PK
05
614041
HI
Enumeration date
12/04/2006
Last updated
07/20/2023
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