Provider Demographics
NPI:1053485144
Name:MACMILLAN, MARY W (RPH)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:W
Last Name:MACMILLAN
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Gender:F
Credentials:RPH
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Mailing Address - Street 1:94-555 ALAPOAI ST
Mailing Address - Street 2:APT 145
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1674
Mailing Address - Country:US
Mailing Address - Phone:808-623-0977
Mailing Address - Fax:808-623-0647
Practice Address - Street 1:3288 MOANALUA RD
Practice Address - Street 2:KP MOANALUA MED CTR ONCOLOGY CLINIC
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1469
Practice Address - Country:US
Practice Address - Phone:808-423-8593
Practice Address - Fax:808-432-8590
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
HI3621835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology