Provider Demographics
NPI:1073531026
Name:DURAN, THOMAS CHARLES (RPH)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:CHARLES
Last Name:DURAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:TOM
Other - Middle Name:
Other - Last Name:DURAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:300 ALA MOANA BLVD
Mailing Address - Street 2:ROOM 6-225
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96850-0001
Mailing Address - Country:US
Mailing Address - Phone:808-541-2732
Mailing Address - Fax:808-541-3887
Practice Address - Street 1:300 ALA MOANA BLVD
Practice Address - Street 2:ROOM 6-225
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96850-0001
Practice Address - Country:US
Practice Address - Phone:808-541-2732
Practice Address - Fax:808-541-3887
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13966183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist