Organization
UPCOUNTRY PHARMACY SERVICES INC
Active
Other names
PARADISE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY LAND RPH (OWNER AND PRESIDENT)
(808) 572-1266
Entity
Organization
Contact information
Practice address
81 MAKAWAO AVE, SUITE 106, MAKAWAO, HI 96768-8895
(808) 572-1266
(808) 572-0745
Mailing address
81 MAKAWAO AVE, SUITE 106, MAKAWAO, HI 96768-8895
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY445
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1202477
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/21/2006
Last updated
12/12/2008
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