Provider Demographics
NPI:1578512638
Name:LAU, GARRETT A
Entity Type:Individual
Prefix:MR
First Name:GARRETT
Middle Name:A
Last Name:LAU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5493A PUULIMA RD
Mailing Address - Street 2:
Mailing Address - City:KALAHEO
Mailing Address - State:HI
Mailing Address - Zip Code:96741-9301
Mailing Address - Country:US
Mailing Address - Phone:808-332-5552
Mailing Address - Fax:808-332-5520
Practice Address - Street 1:3501 RICE ST
Practice Address - Street 2:SUITE #209
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1765
Practice Address - Country:US
Practice Address - Phone:808-240-0200
Practice Address - Fax:808-240-0721
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1721183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist