Mina Pharmacy LTC LLC

Primary specialty

Institutional PharmacyTaxonomy code 3336I0012X

License

PHY-812 Issued in HI

Legal business name

MINA PHARMACY LTC LLC

Doing business as

Mina Pharmacy #14

Practice address

275 W Kaahumanu Ave Ste 1C01A
Kahului, HI 96732-1629

Phone

(808) 856-8030

Fax

(808) 442-9634

NPI assigned

Apr 26, 2012

Organization subpart

No

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

Authorized official

Name

Timothy Moser

Title

Director of Pharmacy

Phone

(808) 738-4540

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mina Pharmacy #14 Doing business as

Tax ID family

Mina Pharmacy 142 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Mina Pharmacy LLC

  dba Mina Pharmacy # 15

  • Point of Service
  • Honolulu, HI
  • NPI 1659760734
  NPD tax ID

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1922366079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 KOAPAKA ST STE F245",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968191881",
            "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 STE 1C01A",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967321629",
            "telephone_number": "808-856-8030",
            "fax_number": "808-442-9634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINA PHARMACY LTC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-26",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "MOSER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "808-738-4540"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "HI",
            "license": "PHY-812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1240833",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mina Pharmacy #14",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Evy Jade Miller
• Kimberly Lani Miller
• Troy Keala Miller
• Phillip Alan Milne, M.D.
• Mina Pharmacy LTC LLC (Mina Pharmacy #15)
• Miyaki Healthcare Services (Pono Physical Therapy)
• Zen Sei Miyashiro, PT, DPT
• Alysha Miyazono, RBT
• Karli Kuulani Oliveira Miyazono, RN
• John T Mizoguchi, OTR

• Institutional Pharmacy in Kahului, HI
• Providers in Kahului, HI by specialty
• Institutional Pharmacy in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.