Provider Demographics
NPI:1013011196
Name:KAM, GEORGIANA C (RPH)
Entity Type:Individual
Prefix:MRS
First Name:GEORGIANA
Middle Name:C
Last Name:KAM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 LOKELANI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-2661
Mailing Address - Country:US
Mailing Address - Phone:808-841-1824
Mailing Address - Fax:808-951-8507
Practice Address - Street 1:966 KAHEKA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2427
Practice Address - Country:US
Practice Address - Phone:808-945-7875
Practice Address - Fax:808-951-8507
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI293183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist