Provider Demographics
NPI:1053454959
Name:DON QUIJOTE (USA) CO., LTD.
Entity Type:Organization
Organization Name:DON QUIJOTE (USA) CO., LTD.
Other - Org Name:DON QUIJOTE DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:K
Authorized Official - Last Name:GUSHIKUMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-973-6600
Mailing Address - Street 1:801 KAHEKA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3725
Mailing Address - Country:US
Mailing Address - Phone:808-973-6600
Mailing Address - Fax:808-973-4844
Practice Address - Street 1:345 HAHANI ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2802
Practice Address - Country:US
Practice Address - Phone:808-266-4434
Practice Address - Fax:808-266-4450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPHY-2913336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00101401Medicaid
120 0738OtherNABP
HIA0261550OtherHMSA PROVIDER