Provider Demographics
NPI:1558747147
Name:HWANG, ALICE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:HWANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 KAMEHAMEHA HWY
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786
Mailing Address - Country:US
Mailing Address - Phone:808-622-1050
Mailing Address - Fax:808-621-2420
Practice Address - Street 1:135 S KAMEHAMEHA HIGHWAY
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-1810
Practice Address - Country:US
Practice Address - Phone:808-622-1050
Practice Address - Fax:808-621-2420
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH3390183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist