Organization
BENUELLI BROTHERS INC
Active
Other names
NORTHSHORE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MAGDI LATIF (PHARMACIST OWNER)
(808) 828-1844
Entity
Organization
Contact information
Practice address
5 4280 KUHIO HWY, PRINCEVILLE, HI 96722
(808) 826-1122
(808) 828-2866
Mailing address
2406 OKA STREET, STE 100, KILAUEA, HI 96754
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY696
HI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1240059
OTHER ID NUMBER
—
Enumeration date
02/08/2008
Last updated
07/01/2008
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