Individual
GREGORY FORMANACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
74-5465 KAMAKAEHA AVE, KAILUA KONA, HI 96740-1648
(808) 326-1707
(808) 334-1173
Mailing address
77-104 KALANIUKA ST, HOLUALOA, HI 96725-9728
(808) 326-1707
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1301
HI
183500000X
Pharmacist
3046
MT
Other
Enumeration date
04/01/2014
Last updated
04/01/2014
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