Provider Demographics
NPI:1235262114
Name:CASTLE MEDICAL CENTER
Entity Type:Organization
Organization Name:CASTLE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:808-263-5192
Mailing Address - Street 1:640 ULUKAHIKI ST
Mailing Address - Street 2:INPATIENT PHARMACY
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4454
Mailing Address - Country:US
Mailing Address - Phone:808-263-5192
Mailing Address - Fax:808-263-5408
Practice Address - Street 1:640 ULUKAHIKI ST
Practice Address - Street 2:INPATIENT PHARMACY
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734
Practice Address - Country:US
Practice Address - Phone:808-263-5192
Practice Address - Fax:808-263-5408
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CASTLE MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-13
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPHY-197282N00000X
HIPHY1973336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIB0501-3Medicaid
HI1201742OtherNCPDP (NATIONAL COUNCIL FOR PRESCRIPTION DRUG PROGRAMS)