NPIMap

Organization Active NPI

Foodland Lab #30

  • Clinical Medical Laboratory
  • Princeville, HI
National Provider Identifier
1811388267
Registry record updated Feb 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
14-CP1-359 Issued in HI
Legal business name
FOODLAND LAB #30
Practice address
5-4280 Kuhio Highway
Princeville, HI 96722
Phone
(808) 826-4228
Fax
(808) 826-4199
NPI assigned
Feb 6, 2015
Last updated
Feb 6, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
FOODLAND SUPERMARKET LTD.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 6, 2015

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

Authorized official

Name
Jaclyn Moore, PHARM DNPI 1073669354
Title
Lab Director
Phone
(808) 885-2075

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 14-CP1-359 HI Primary

Addresses

Primary practice location

5-4280 Kuhio Highway
Princeville, HI 96722

Mailing address

PO Box 223005
Princeville, HI 96722-3005
Phone (808) 826-4228

National Provider Directory

National Provider Directory
Tax ID family
Foodland Super Market Limited9 organizations share this tax ID, including this one
Part of
Foodland Super Market Limited

Other organizations with this tax ID 8

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423180800000",
    "number": "1811388267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 223005",
            "city": "PRINCEVILLE",
            "state": "HI",
            "postal_code": "967223005",
            "telephone_number": "808-826-4228",
            "fax_number": "808-826-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5-4280 KUHIO HIGHWAY",
            "city": "PRINCEVILLE",
            "state": "HI",
            "postal_code": "96722",
            "telephone_number": "808-826-4228",
            "fax_number": "808-826-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOODLAND LAB #30",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOODLAND SUPERMARKET LTD.",
        "enumeration_date": "2015-02-06",
        "last_updated": "2015-02-06",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "LAB DIRECTOR",
        "authorized_official_telephone_number": "808-885-2075",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "HI",
            "license": "14-CP1-359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeville, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; 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.