Provider Demographics
NPI:1780660191
Name:PHARMACY PARTNERS HAWAII LLC
Entity Type:Organization
Organization Name:PHARMACY PARTNERS HAWAII LLC
Other - Org Name:PHARMACARE LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:N
Authorized Official - Last Name:YOSHINO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:808-840-5656
Mailing Address - Street 1:3375 KOAPAKA STREET
Mailing Address - Street 2:SUITE G320
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1898
Mailing Address - Country:US
Mailing Address - Phone:808-836-0223
Mailing Address - Fax:808-836-0537
Practice Address - Street 1:3375 KOAPAKA STREET
Practice Address - Street 2:SUITE F251
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1898
Practice Address - Country:US
Practice Address - Phone:808-840-5690
Practice Address - Fax:808-485-8927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-16
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPHY6583336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI56501201Medicaid
2019424OtherPK
2019424OtherPK