Mina Pharmacy LTC LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY-813 Issued in HI

Legal business name

MINA PHARMACY LTC LLC

Doing business as

Mina Pharmacy #15

Practice address

275 W. Kaahumanu Ave
#1C01
Kahului, HI 96732

Phone

(808) 856-3070

Fax

(808) 442-9635

NPI assigned

Apr 25, 2012

Last updated

May 6, 2014By 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

Adel Etinas, RPH

Title

President

Phone

(808) 738-4540

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mina Pharmacy #15 Doing business as

Locations

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1740548981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 KOAPAKA STREET",
            "address_2": "F245",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96819",
            "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": "275 W. KAAHUMANU AVE",
            "address_2": "#1C01",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "96732",
            "telephone_number": "808-856-3070",
            "fax_number": "808-442-9635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINA PHARMACY LTC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "ETINAS",
        "authorized_official_first_name": "ADEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-738-4540",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "HI",
            "license": "PHY-813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1240821",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mina Pharmacy #15",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Millennium Nurse of Hawaii
• Evy Jade Miller
• Kimberly Lani Miller
• Troy Keala Miller
• Phillip Alan Milne, M.D.
• Mina Pharmacy LTC LLC (Mina Pharmacy #14)
• Miyaki Healthcare Services (Pono Physical Therapy)
• Zen Sei Miyashiro, PT, DPT
• Alysha Miyazono, RBT
• Karli Kuulani Oliveira Miyazono, RN

• Community/Retail Pharmacy in Kahului, HI
• Providers in Kahului, 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 May 6, 2014; 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.