Provider Demographics
NPI:1093861478
Name:FUKUSHIMA, LAURIE HIROKO (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:HIROKO
Last Name:FUKUSHIMA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 331162
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96733-1162
Mailing Address - Country:US
Mailing Address - Phone:808-243-6107
Mailing Address - Fax:808-243-6586
Practice Address - Street 1:55 MAUILANI PKWY
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2416
Practice Address - Country:US
Practice Address - Phone:808-243-6107
Practice Address - Fax:808-243-6568
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-2437183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist