Provider Demographics
NPI:1528023777
Name:SHIIGI DRUG CO., INC.
Entity Type:Organization
Organization Name:SHIIGI DRUG CO., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:H
Authorized Official - Last Name:MATSUKADO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:808-935-0001
Mailing Address - Street 1:333 KILAUEA AVE
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3013
Mailing Address - Country:US
Mailing Address - Phone:808-935-0001
Mailing Address - Fax:808-969-9833
Practice Address - Street 1:333 KILAUEA AVE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3013
Practice Address - Country:US
Practice Address - Phone:808-935-0001
Practice Address - Fax:808-969-9833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPHY-169332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI57251201Medicaid
HIP7893OtherHMSA
HI00791901Medicaid
HI00791901Medicaid