Gregory Formanack, R.PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

1301 Issued in HI

Practice address

74-5465 Kamakaeha Ave
Kailua Kona, HI 96740-1648

Phone

(808) 326-1707

Fax

(808) 334-1173

NPI assigned

Apr 1, 2014

Last updated

Apr 1, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1063830644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77-104 KALANIUKA ST",
            "city": "HOLUALOA",
            "state": "HI",
            "postal_code": "967259728",
            "telephone_number": "808-326-1707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74-5465 KAMAKAEHA AVE",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401648",
            "telephone_number": "808-326-1707",
            "fax_number": "808-334-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMANACK",
        "first_name": "GREGORY",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-01",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "HI",
            "license": "1301",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "3046",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Pharmacist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.