Provider Demographics
NPI:1619029733
Name:SANTELLA, EMILYN SAROL (CPHT)
Entity Type:Individual
Prefix:MISS
First Name:EMILYN
Middle Name:SAROL
Last Name:SANTELLA
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 KUMUKAHI ST
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-2158
Mailing Address - Country:US
Mailing Address - Phone:808-661-5160
Mailing Address - Fax:
Practice Address - Street 1:910 WAINEE ST
Practice Address - Street 2:
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-1622
Practice Address - Country:US
Practice Address - Phone:808-662-6945
Practice Address - Fax:808-662-6940
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2001-1207-7170-437183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician