Organization
MINA CORPORATION
Active
Other names
Mina Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ADEL ETINAS (PRESIDENT,CEO)
(808) 222-9252
Entity
Organization
Contact information
Practice address
599 FARRINGTON HWY STE 101, KAPOLEI, HI 96707-2028
(808) 672-6760
(808) 356-3392
Mailing address
599 FARRINGTON HWY, #101, KAPOLEI, HI 96707-2028
(808) 672-6760
(808) 356-3392
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PHY-887
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153011
PK
—
Enumeration date
07/10/2015
Last updated
07/10/2015
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