Individual provider Active NPI

Marada Decker Jr., RPH

  • Pharmacist
  • Wailuku, HI
National Provider Identifier
1851674477
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
449 Issued in HI
Practice address
2180 Main St
#102
Wailuku, HI 96793-1625
Phone
(808) 244-7252
Fax
(808) 242-5837
NPI assigned
Sep 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 449 HI Primary

Addresses

Primary practice location

2180 Main St
#102
Wailuku, HI 96793-1625

Mailing address

2180 Main St
#102
Wailuku, HI 96793-1625
Phone (808) 244-7252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
449HIMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1851674477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 MAIN ST",
            "address_2": "#102",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931625",
            "telephone_number": "808-244-7252",
            "fax_number": "808-242-5837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 MAIN ST",
            "address_2": "#102",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931625",
            "telephone_number": "808-244-7252",
            "fax_number": "808-242-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "MARADA",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "HI",
            "license": "449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; 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.