Organization
KAUAI REGION PHARMACY WEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH M VANDEN BUSSCHE (LEAD RETAIL PHARMACIST)
(808) 338-2450
Entity
Organization
Contact information
Practice address
4643 WAIMEA CANYON DR., WAIMEA, HI 96796
(808) 338-2450
(808) 338-2451
Mailing address
PO BOX 337, WAIMEA, HI 96796
(808) 338-2450
(808) 338-2451
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
05/06/2021
Last updated
05/06/2021
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