Provider Demographics
NPI:1114017621
Name:OKAMURA, KERRI C (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:C
Last Name:OKAMURA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 KIPUNI ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-6049
Mailing Address - Country:US
Mailing Address - Phone:808-959-4575
Mailing Address - Fax:808-981-0385
Practice Address - Street 1:50 E PUAINAKO ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-5242
Practice Address - Country:US
Practice Address - Phone:808-959-4575
Practice Address - Fax:808-981-0385
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH1731183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist