1609945187 NPI number — PHARM NEUT INC

Table of content: (NPI 1609945187)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609945187 NPI number — PHARM NEUT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHARM NEUT INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609945187
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
850 W HIND DR
Provider Second Line Business Mailing Address:
#111
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96821-1845
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-373-5151
Provider Business Mailing Address Fax Number:
808-373-5196

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
850 W HIND DR
Provider Second Line Business Practice Location Address:
#111
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96821-1845
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-373-5151
Provider Business Practice Location Address Fax Number:
808-373-5196
Provider Enumeration Date:
11/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PREBULA
Authorized Official First Name:
BONNIE
Authorized Official Middle Name:
G
Authorized Official Title or Position:
CORP PRES V PRES
Authorized Official Telephone Number:
808-373-5151

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0001203859 . This is a "RX AMERICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 120385 . This is a "WALGREENS HEALTH INITIATI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1203859 . This is a "CAREMARK NABP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1203859 . This is a "AETNA NABP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1203859 . This is a "EXPRESS SCRIPTS NABP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1203859 . This is a "MEMBER HEALTH INC NABP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1203859 . This is a "WELL POINT NABP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00223933 . This is a "HMSA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 12038 . This is a "PRESCRIPTION SOLUTIONS NA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1203859 . This is a "WEB MD NABP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1203859 . This is a "ARGUS NABP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1203859 . This is a "RESTAT NABP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 25011701 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".




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