Pacific Health Pharmacy LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PHY681 Issued in HI

Legal business name

PACIFIC HEALTH PHARMACY LLC

Practice address

2875 Koapaka St
Ste B
Honolulu, HI 96819-1921

Phone

(808) 833-3414

Fax

(808) 833-3416

NPI assigned

Dec 11, 2006

Last updated

Jul 26, 2007By 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

Daryleann Ho

Title

Managing Director

Phone

(808) 833-3414

Specialties & licenses 8

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185408000000",
    "number": "1699835827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 KOAPAKA ST",
            "address_2": "STE B",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 KOAPAKA ST",
            "address_2": "STE B",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191921",
            "telephone_number": "808-833-3414",
            "fax_number": "808-833-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC HEALTH PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-26",
        "status": "A",
        "authorized_official_last_name": "HO",
        "authorized_official_first_name": "DARYLEANN",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "808-833-3414"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "HI",
            "license": "PHY681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "590580",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1239842",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "1239842",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pacific Health Inc
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• Pacific Maxillofacial Center, LLC
• Pacific Maxillofacial Center, LLC

• Compounding Pharmacy in Honolulu, HI
• Providers in Honolulu, HI by specialty
• Compounding Pharmacy in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.

Verify at the official NPI Registry.