Provider Demographics
NPI:1083756753
Name:CLINICAL PHARMACY CONSULTANTS
Entity Type:Organization
Organization Name:CLINICAL PHARMACY CONSULTANTS
Other - Org Name:PONAHAWAI PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:W
Authorized Official - Last Name:BARTY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:808-732-8826
Mailing Address - Street 1:670 PONAHAWAI ST
Mailing Address - Street 2:SUITE 213
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2660
Mailing Address - Country:US
Mailing Address - Phone:808-933-8555
Mailing Address - Fax:808-933-3070
Practice Address - Street 1:670 PONAHAWAI ST
Practice Address - Street 2:SUITE 213
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2660
Practice Address - Country:US
Practice Address - Phone:808-933-8555
Practice Address - Fax:808-933-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPHY-3363336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI000001547-9OtherHMSA
HI0000015479OtherHMSA QUEST
1200093OtherNABP
1200093OtherNCPDP