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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