NPIMap

Organization Active NPI

Mina Corporation

  • Compounding Pharmacy
  • Kealakekua, HI
National Provider Identifier
1639416605
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Compounding PharmacyTaxonomy code 3336C0004X
License
PHY826 Issued in HI
Legal business name
MINA CORPORATION
Practice address
81 6629 Mamalahoa Hwy
Kealakekua, HI 96750
Phone
(808) 324-6888
Fax
(808) 324-7888
NPI assigned
Jan 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

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

Authorized official

Name
Adel Etinas
Title
President, Ceo
Phone
(808) 738-4540

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Compounding Pharmacy 3336C0004X PHY826 HI Primary

Addresses

Primary practice location

81 6629 Mamalahoa Hwy
Kealakekua, HI 96750

Mailing address

3375 Koapaka St Ste F245
Honolulu, HI 96819-1881
Phone (808) 738-4540

Other identifiers 1

IdentifierTypeStateIssuer
1241025OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Mina Pharmacy #18 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mina Corporation5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357862400000",
    "number": "1639416605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 KOAPAKA ST STE F245",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191881",
            "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": "81 6629 MAMALAHOA HWY",
            "city": "KEALAKEKUA",
            "state": "HI",
            "postal_code": "96750",
            "telephone_number": "808-324-6888",
            "fax_number": "808-324-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINA CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-11",
        "last_updated": "2013-01-11",
        "status": "A",
        "authorized_official_last_name": "ETINAS",
        "authorized_official_first_name": "ADEL",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "808-738-4540"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "HI",
            "license": "PHY826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1241025",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mina Pharmacy #18",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kealakekua, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; 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.