Organization
QUEEN'S DEVELOPMENT CORPORATION & SUBSIDIARIES
Active
Parent organization
QUEEN'S DEVELOPMENT CORPORATION & SUBSIDIARIES
Other names
QUEEN'S POB II PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
QUEEN'S DEVELOPMENT CORPORATION & SUBSIDIARIES
Authorized official
DR. GAVIN SANJUME PHARM.D. (DIRECTOR)
(808) 691-4342
Entity
Organization
Contact information
Practice address
1329 LUSITANA ST, STE 101, HONOLULU, HI 96813-2429
(808) 691-4560
(808) 691-4072
Mailing address
1329 LUSITANA ST STE 101, HONOLULU, HI 96813-2401
(808) 691-4560
(808) 691-4072
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PHY-465
HI
332BD1200X
Dialysis Equipment & Supplies (DME)
PHY-465
HI
332BN1400X
Nursing Facility Supplies (DME)
PHY-465
HI
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
PHY-465
HI
333600000X
Pharmacy
Primary
PHY-465
HI
335E00000X
Prosthetic/Orthotic Supplier
PHY-465
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085381-01
—
HI
01
—
1202578
NCPDP NUMBER
HI
Enumeration date
08/04/2005
Last updated
07/26/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us