Provider Demographics
NPI:1326031279
Name:KUAKINI DEVELOPMENT CORPORATION
Entity Type:Organization
Organization Name:KUAKINI DEVELOPMENT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:KAJIWARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-547-9231
Mailing Address - Street 1:321 N KUAKINI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2364
Mailing Address - Country:US
Mailing Address - Phone:808-547-9231
Mailing Address - Fax:
Practice Address - Street 1:321 N KUAKINI ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2364
Practice Address - Country:US
Practice Address - Phone:808-547-9231
Practice Address - Fax:808-547-9547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-25
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10097902333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI10097902OtherSTATE ID
HI251855-01Medicaid
HI0000953172OtherDEPT OF LABOR
HI0000953172OtherDEPT OF LABOR