Provider Demographics
NPI:1033516836
Name:WAIKIKI HEALTH CENTER PHARMACY 2
Entity Type:Organization
Organization Name:WAIKIKI HEALTH CENTER PHARMACY 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-791-9302
Mailing Address - Street 1:277 OHUA AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-6612
Mailing Address - Country:US
Mailing Address - Phone:808-922-4787
Mailing Address - Fax:
Practice Address - Street 1:935 MAKAHIKI WAY
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-2896
Practice Address - Country:US
Practice Address - Phone:808-739-7363
Practice Address - Fax:808-924-7243
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WAIKIKI HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPHY8593336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy