Provider Demographics
NPI:1497798110
Name:KRENK, LESLIE J (RPH)
Entity Type:Individual
Prefix:MR
First Name:LESLIE
Middle Name:J
Last Name:KRENK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 PUUNENE AVE
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2121
Mailing Address - Country:US
Mailing Address - Phone:808-877-6222
Mailing Address - Fax:808-877-0504
Practice Address - Street 1:53 PUUNENE AVE
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2121
Practice Address - Country:US
Practice Address - Phone:808-877-6222
Practice Address - Fax:808-877-0504
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI470183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist