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Individual

MR. LOREN LEE WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
1010 PENSACOLA ST, HONOLULU, HI 96814-2118
(808) 432-2065
Mailing address
1287 ULUPALAKUA ST, KAILUA, HI 96734-4349
(808) 262-3987

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH-618
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PH-618
PHARMACIST LICENSE NUMBER
HI
Enumeration date
02/01/2007
Last updated
07/08/2007
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