MINA PHARMACY LTC, LLC; NPI #1770750911

Contact Information

MINA PHARMACY LTC, LLC

1251 KILAUEA AVE
#190C-1
HILO, HI 96720-8509

Phone: 808-935-3100
Fax: 808-935-6800
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Long Term Care Pharmacy	3336L0003X	58	Medical Supply Company with Pharmacist

Indicates primary specialty

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NPI Profile & details for MINA PHARMACY LTC, LLC

NPI Number 1770750911

LBN Legal business name MINA PHARMACY LTC, LLC

Authorized official ADEL ETINAS - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/15/2008

Last updated 09/08/2011 - About 15 years ago

Identifiers

HI	License #	PHY707
	Other	1240124	NCPDP PROVIDER IDENTIFICATION NUMBER

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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