Mina Pharmacy LTC, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY-687 Issued in HI

Legal business name

MINA PHARMACY LTC, LLC

Practice address

75-5995 Kuakini Hwy
#513A
Kailua Kona, HI 96740-2124

Phone

(808) 329-1000

Fax

(808) 329-1005

NPI assigned

Jan 12, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Adel Etinas, RPH

Title

President,Ceo

Phone

(808) 738-4540

Specialties & licenses 1

Addresses

Other names 1

• Mina pharmacy#6 Doing business as

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380758400000",
    "number": "1780734376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 KOAPAKA STREET,",
            "address_2": "SUITE F245",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191816",
            "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": "75-5995 KUAKINI HWY",
            "address_2": "#513A",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402124",
            "telephone_number": "808-329-1000",
            "fax_number": "808-329-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINA PHARMACY LTC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2013-10-03",
        "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",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "HI",
            "license": "PHY-687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mina pharmacy#6",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Khalil Kyle Midani, LAC
• Jacquelyn Mikelson
• Joe Miller, M.D.
• Caleb Milliken
• Casey Milnes, D.V.M
• Mina Pharmacy LTC, LLC
• Vesela Ivanova Mincheva, LMT
• Mind Body Nutrition RN
• Mindful Flow LLC
• Mindful Roots Therapy LLC

• Community/Retail Pharmacy in Kailua Kona, HI
• Providers in Kailua Kona, 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 Oct 3, 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.