Provider Demographics
NPI:1396197182
Name:BRIAN A CARTER INC
Entity Type:Organization
Organization Name:BRIAN A CARTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-645-0491
Mailing Address - Street 1:PO BOX 526
Mailing Address - Street 2:
Mailing Address - City:HANAPEPE
Mailing Address - State:HI
Mailing Address - Zip Code:96716-0526
Mailing Address - Country:US
Mailing Address - Phone:808-645-0491
Mailing Address - Fax:808-335-0043
Practice Address - Street 1:1-3845 KAUMUALII HIGHWAY
Practice Address - Street 2:SUITE B
Practice Address - City:HANAPEPE
Practice Address - State:HI
Practice Address - Zip Code:96716-0526
Practice Address - Country:US
Practice Address - Phone:808-645-0491
Practice Address - Fax:808-335-0043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-06
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
HIPHY-9113336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2160856OtherPK