Garden Island Pharmacy Serv, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY-406 Issued in HI

Legal business name

GARDEN ISLAND PHARMACY SERV, INC

Doing business as

Southshore Pharmacy

Practice address

5330 Koloa Rd
BX 160
Koloa, HI 96756-8604

Phone

(808) 338-0200

NPI assigned

Feb 15, 2007

Last updated

Aug 22, 2020By 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

Stewart L Swacker, R.PH.

Title

President

Phone

(808) 338-0200

Specialties & licenses 1

Addresses

Other names 1

• SOUTHSHORE PHARMACY Doing business as

Tax ID family

Garden Island Pharmacy Serv Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Garden Island Pharmacy Serv, Inc

  dba Menehune Pharmacy

  • Community/Retail Pharmacy
  • Waimea, HI
  • NPI 1669514691
  NPD tax ID

Locations

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295879237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5330 KOLOA RD",
            "city": "KOLOA",
            "state": "HI",
            "postal_code": "967568604",
            "telephone_number": "808-338-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 KOLOA RD",
            "address_2": "BX 160",
            "city": "KOLOA",
            "state": "HI",
            "postal_code": "967568604",
            "telephone_number": "808-338-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN ISLAND PHARMACY SERV, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SWACKER",
        "authorized_official_first_name": "STEWART",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-338-0200",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "HI",
            "license": "PHY-406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHSHORE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Edward Franklin De Deo, D.C.
• Kerry L Dillberg, DC, L.AC.
• Ameen Fayek Elwir
• Homayra Fahmida, APRN
• Diane Faye, M. EDUCATION
• Hale Kupuna Heritage Home, LLC
• Healing in Waves Therapy and Wellness LLC
• Molly R Heublein, MD
• Iaomai 4 LLC (Lifeway Pharmacy (Koloa))
• Iaomai 4 LLC (Lifeway Pharmacy (Koloa))

• Community/Retail Pharmacy in Koloa, HI
• Providers in Koloa, 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 Aug 22, 2020; 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.