Provider Demographics
NPI:1295880169
Name:DON QUIJOTE (USA) CO.,LTD
Entity type:Organization
Organization Name:DON QUIJOTE (USA) CO.,LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:K
Authorized Official - Last Name:GUSHIKUMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-973-6600
Mailing Address - Street 1:801 KAHEKA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3725
Mailing Address - Country:US
Mailing Address - Phone:808-973-6600
Mailing Address - Fax:808-976-4844
Practice Address - Street 1:94-144 FARRINGTON HWY
Practice Address - Street 2:ATTENTION PHARMACY
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-1901
Practice Address - Country:US
Practice Address - Phone:808-678-6831
Practice Address - Fax:808-671-3946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPHY-5583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1203520OtherNCPDP#(NABP#)
HIB026155-8OtherHMSA PROVIDER #
HI00101601Medicaid