NPIMap

Organization Active NPI

Foodland Lab #28

  • Clinical Medical Laboratory
  • Kapa'a, HI
National Provider Identifier
1285024794
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
14-CP1-358 Issued in HI
Legal business name
FOODLAND LAB #28
Practice address
4-771 Kuhio Hwy Ste 101
Kapaa, HI 96746-2719
Phone
(808) 821-6979
Fax
(808) 821-6977
NPI assigned
Feb 4, 2015
Last updated
Feb 4, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
FOODLAND SUPERMARKET LTD,As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Authorized official

Name
Jaclyn Moore, PHARM DNPI 1073669354
Title
Lab Director
Phone
(808) 885-2075

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 14-CP1-358 HI Primary

Addresses

Primary practice location

4-771 Kuhio Hwy Ste 101
Kapaa, HI 96746-2719

Mailing address

4-771 Kuhio Hwy Ste 101
Kapaa, HI 96746-2719
Phone (808) 821-6979

National Provider Directory

National Provider Directory
Tax ID family
Foodland Super Market Limited9 organizations share this tax ID, including this one
Part of
Foodland Super Market Limited

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4-771 Kuhio Hwy
Ste 101
Kapaa, HI 96746
Phone (808) 821-6979

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423008000000",
    "number": "1285024794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4-771 KUHIO HWY STE 101",
            "city": "KAPAA",
            "state": "HI",
            "postal_code": "967462719",
            "telephone_number": "808-821-6979",
            "fax_number": "808-821-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4-771 KUHIO HWY STE 101",
            "city": "KAPAA",
            "state": "HI",
            "postal_code": "967462719",
            "telephone_number": "808-821-6979",
            "fax_number": "808-821-6977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOODLAND LAB #28",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOODLAND SUPERMARKET LTD,",
        "enumeration_date": "2015-02-04",
        "last_updated": "2015-02-04",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "LAB DIRECTOR",
        "authorized_official_telephone_number": "808-885-2075",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "HI",
            "license": "14-CP1-358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kapa'a, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.