Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUTHANA TEPRASEUTH (PHARMACIST IN CHARGE)
(808) 432-5702
Entity
Organization
Contact information
Practice address
2828 PA A ST, STE 2400, HONOLULU, HI 96819
(808) 432-5760
(808) 432-5759
Mailing address
2828 PA A ST, STE 2400, HONOLULU, HI 96819
(808) 432-5760
(808) 432-5759
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
Primary
PHY-671
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019440
PK
—
05
—
58099501
—
HI
Enumeration date
05/24/2006
Last updated
06/09/2017
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