Ctiy Pharmacy Kapahulu, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY515 Issued in HI

Legal business name

CTIY PHARMACY KAPAHULU, INC.

Practice address

750 Palani Ave
Honolulu, HI 96816-1109

Phone

(808) 739-1188

Fax

(808) 735-6545

NPI assigned

Jul 31, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Carl Phillip Mudrick, R.PH.

Title

Pharmacist-Manager

Phone

(808) 739-1188

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• City Pharmacy Kapahulu Doing business as

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861407249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 PALANI AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968161109",
            "telephone_number": "808-739-1188",
            "fax_number": "808-735-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 PALANI AVE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968161109",
            "telephone_number": "808-739-1188",
            "fax_number": "808-735-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CTIY PHARMACY KAPAHULU, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MUDRICK",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "PHARMACIST-MANAGER",
        "authorized_official_telephone_number": "808-739-1188",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "HI",
            "license": "PHY515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00445401",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City Pharmacy Kapahulu",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kathleen Cruz, D.M.D.
• Nicolle Cruz, LSW
• Rochelle Langit Cruz
• Sandra J. Cruz, NP
• Tara Kahealani Cruz, RN
• Amber H Cuban
• Thad Analu Cuban, CSAC
• Joseph Cucolo, D.D.S
• Myrella Lizeth Cuellar
• Eugenie Louise Orillosa Cuerdo, M.D.

• Community/Retail Pharmacy in Honolulu, HI
• Providers in Honolulu, 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 Aug 22, 2020; 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.