Provider Demographics
NPI:1801965389
Name:PHARM NEUT INC
Entity type:Organization
Organization Name:PHARM NEUT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORP PRES V PRES
Authorized Official - Prefix:MRS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:PREBULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-965-5629
Mailing Address - Street 1:PO BOX 1433
Mailing Address - Street 2:#1 GOVERNMENT RD
Mailing Address - City:PAHOA
Mailing Address - State:HI
Mailing Address - Zip Code:96778-1433
Mailing Address - Country:US
Mailing Address - Phone:808-965-7535
Mailing Address - Fax:808-965-6159
Practice Address - Street 1:#1 GOVERNMENT RD
Practice Address - Street 2:
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778-1433
Practice Address - Country:US
Practice Address - Phone:808-965-7535
Practice Address - Fax:808-965-6159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NABP1202667OtherRX SOLUTIONS
HI02592601Medicaid
NABP1202667OtherEXPRESS SCRIPTS
NABP1202667028900001OtherARGUS
NABP0001202667OtherRX AMERICA
NABP1202667OtherRESTAT
000001342NABP1202667OtherCAREMARK
NABP1202667OtherWALGREENS HEALTH INITATIV
NABP1202667OtherPROSERV
0000228007OtherHMSA
1202667OtherMEMBER HEALTH INC
NABP1202667OtherEXPRESS SCRIPTS