Provider Demographics
NPI:1578867768
Name:QUIMBY, LARRY SUMNER (RPH)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:SUMNER
Last Name:QUIMBY
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 1:1010 S KING ST
Mailing Address - Street 2:SUITE 704
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1701
Mailing Address - Country:US
Mailing Address - Phone:808-312-3437
Mailing Address - Fax:808-312-3441
Practice Address - Street 1:1010 S KING ST
Practice Address - Street 2:SUITE 704
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1701
Practice Address - Country:US
Practice Address - Phone:808-312-3437
Practice Address - Fax:808-312-3441
Is Sole Proprietor?:No
Enumeration Date:2011-01-01
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-2269183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist