1184736803 NPI number — DR. DOUGLAS B ADRIANCE JR. PHARM.D.

Table of content: DR. DOUGLAS B ADRIANCE JR. PHARM.D. (NPI 1184736803)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184736803 NPI number — DR. DOUGLAS B ADRIANCE JR. PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADRIANCE
Provider First Name:
DOUGLAS
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
PHARM.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ADRIANCE-MEJIA
Provider Other First Name:
DOUGLAS
Provider Other Middle Name:
B
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARM,D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1184736803
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1115 AINAKO AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HILO
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96720-1505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-345-1533
Provider Business Mailing Address Fax Number:
808-969-7686

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34 RAINBOW DR
Provider Second Line Business Practice Location Address:
UNIVERSITY OF HAWAII HILO COLLEGE OF PHARMACY
Provider Business Practice Location Address City Name:
HILO
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-934-4086
Provider Business Practice Location Address Fax Number:
808-969-7686
Provider Enumeration Date:
08/31/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  5097051-1701 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: PH-2449 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)