Mina Pharmacy LTC, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY706 Issued in HI

Legal business name

MINA PHARMACY LTC, LLC

Doing business as

Mina Pharmacy

Practice address

1251 Kilauea Ave
#190C
Hilo, HI 96720-8509

Phone

(808) 935-3100

Fax

(808) 935-6800

NPI assigned

May 5, 2008

Last updated

Jan 13, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Adel Etinas

Title

President

Phone

(808) 738-4540

Specialties & licenses 1

Addresses

Other names 1

• MINA PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1275709834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 KOAPAKA STREET",
            "address_2": "SUITE F245",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191816",
            "telephone_number": "808-738-4540",
            "fax_number": "808-690-9174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 KILAUEA AVE",
            "address_2": "#190C",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967208509",
            "telephone_number": "808-935-3100",
            "fax_number": "808-935-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINA PHARMACY LTC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-05",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "ETINAS",
        "authorized_official_first_name": "ADEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-738-4540",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "HI",
            "license": "PHY706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MINA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Avrille Miller, RN
• Debra Miller
• Fauna Miller
• Richard John Miller
• Amberlyn Milum
• Mina Pharmacy LTC, LLC (Mina Pharmacy LTC)
• Nikki Minami, RN
• Isabel Miranda
• Emily Mischke
• Rachael Karla Misitano, NP

• Community/Retail Pharmacy in Hilo, HI
• Providers in Hilo, HI by specialty
• Community/Retail Pharmacy in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.