Provider Demographics
NPI:1922631795
Name:FUSELIER, JAMES ALTON (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALTON
Last Name:FUSELIER
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 1:66-495 KILIOE PL
Mailing Address - Street 2:
Mailing Address - City:HALEIWA
Mailing Address - State:HI
Mailing Address - Zip Code:96712-1430
Mailing Address - Country:US
Mailing Address - Phone:808-781-1647
Mailing Address - Fax:
Practice Address - Street 1:1290 S BERETANIA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1513
Practice Address - Country:US
Practice Address - Phone:808-522-5071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-2039183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist