Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER KAILUA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY NISHINA (PHARMACIST IN CHARGE)
(808) 432-3451
Entity
Organization
Contact information
Practice address
201 HAMAKUA DR BLDG B, KAILUA, HI 96734-3984
(808) 432-3450
(808) 432-3459
Mailing address
201 HAMAKUA DR BLDG B, KAILUA, HI 96734-3984
(808) 432-3450
(808) 432-3459
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
Primary
PHY451
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018328
PK
—
05
—
54322401
—
HI
Enumeration date
02/09/2007
Last updated
02/28/2017
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