Provider Demographics
NPI:1114132776
Name:STRAUB CLINIC & HOSPITAL (LANAI CLINIC PHARMACY)
Entity Type:Organization
Organization Name:STRAUB CLINIC & HOSPITAL (LANAI CLINIC PHARMACY)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO, SR., VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:OKABE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-535-7202
Mailing Address - Street 1:1946 YOUNG ST
Mailing Address - Street 2:SUITE 360
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-2150
Mailing Address - Country:US
Mailing Address - Phone:808-973-7320
Mailing Address - Fax:808-973-7325
Practice Address - Street 1:628 B SEVENTH ST
Practice Address - Street 2:
Practice Address - City:LANAI CITY
Practice Address - State:HI
Practice Address - Zip Code:96763
Practice Address - Country:US
Practice Address - Phone:808-565-6423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy