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Organization

G CORP DBA MAUI HOME INFUSION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEVIN GLICK RPH (PRESIDENT)
(808) 245-1864
Entity
Organization

Contact information

Practice address
60 E WAKEA AVE, SUITE 116, KAHULUI, HI 96732-2466
(808) 871-4663
(808) 893-2001
Mailing address
4473 PAHEE ST, SUITE I, LIHUE, HI 96766-2037
(808) 871-4663
(808) 893-2001

Taxonomy

Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
PHY598
HI

Other

Enumeration date
12/21/2005
Last updated
08/22/2020
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