Provider Demographics
NPI:1255658324
Name:HAWAII IRX, LLC
Entity Type:Organization
Organization Name:HAWAII IRX, LLC
Other - Org Name:HAWAII ASCEND PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-228-1391
Mailing Address - Street 1:2441 WARRENVILLE RD STE 610
Mailing Address - Street 2:C/O SXC HEALTH SOLUTIONS
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-3642
Mailing Address - Country:US
Mailing Address - Phone:630-577-3100
Mailing Address - Fax:630-288-9825
Practice Address - Street 1:2875 B KOAPAKA STREET
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819
Practice Address - Country:US
Practice Address - Phone:800-850-9122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPHY7823336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy