Lisandra Blanco Pena
Individual provider Active NPI Pharmacist · Mililani, HI
NPI 1992371371 · NPPES record last updated May 27, 2021
Key facts
- NPI
- 1992371371
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 4587 (HI)
- Practice address
- 95-1077 Ainamakua Dr
Mililani, HI 96789-4252 - Phone
- (808) 626-2380
- NPI assigned
- May 27, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4587 | HI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Stores California LLC | Past |
Accepting new patients | |
| Longs Drug Store California LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4587 | HI | Yes |
Addresses
Primary practice location
95-1077 Ainamakua Dr
Mililani, HI 96789-4252
Mailing address
95-1077 Ainamakua Dr
Mililani, HI 96789-4252
Other providers in Mililani, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.