Active NPI
Tyrus Park, RPH
- Pharmacist
- Mililani, HI
National Provider Identifier
1275746240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 1586
- Practice address
- 94-780A Meheula Pkwy
Mililani, HI 96789 - Phone
- (808) 623-6636
- Fax
- (808) 625-3894
- NPI assigned
- May 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 1586 | HI | Primary |
Addresses
Primary practice location
94-780A Meheula Pkwy
Mililani, HI 96789
Mailing address
141 N Civic Dr
Walnut Creek, CA 94596
Phone (925) 210-6659
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1586 | HI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275746240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 N CIVIC DR",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "94596",
"telephone_number": "925-210-6659",
"fax_number": "925-210-6606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94-780A MEHEULA PKWY",
"city": "MILILANI",
"state": "HI",
"postal_code": "96789",
"telephone_number": "808-623-6636",
"fax_number": "808-625-3894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "TYRUS",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "HI",
"license": "1586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mililani, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.