Mina Pharmacy LTC, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHY-686 Issued in HI

Legal business name

MINA PHARMACY LTC, LLC

Doing business as

Mina Pharmacy#5 LTC

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

Phone

(808) 738-4540

Specialties & licenses 1

Addresses

Other names 1

• Mina Pharmacy#5 LTC Doing business as

Locations

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322524800000",
    "number": "1942350525",
    "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": "2011-11-29",
        "status": "A",
        "authorized_official_last_name": "ETINAS",
        "authorized_official_first_name": "ADEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-738-4540",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "HI",
            "license": "PHY-686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mina Pharmacy#5 LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacquelyn Mikelson
• Joe Miller, M.D.
• Caleb Milliken
• Casey Milnes, D.V.M
• Mina Pharmacy LTC, LLC
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• Heather Miner, M.D.

• Pharmacy in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Pharmacy in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.