Organization
MINA CORPORATION
Active
Other names
Mina Pharmacy #18
Organization subpart
No
Provider details
NPI number
Authorized official
ADEL ETINAS (PRESIDENT, CEO)
(808) 738-4540
Entity
Organization
Contact information
Practice address
81 6629 MAMALAHOA HWY, KEALAKEKUA, HI 96750
(808) 324-6888
(808) 324-7888
Mailing address
3375 KOAPAKA ST STE F245, HONOLULU, HI 96819-1881
(808) 738-4540
(808) 690-9174
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PHY826
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1241025
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/11/2013
Last updated
01/11/2013
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