Basic Information
| Provider Information | |||||||||
| NPI: | 1114132776 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | STRAUB CLINIC & HOSPITAL (LANAI CLINIC PHARMACY) | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1946 YOUNG ST | ||||||||
| Address2: | SUITE 360 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968262150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089737320 | ||||||||
| FaxNumber: | 8089737325 | ||||||||
| Practice Location | |||||||||
| Address1: | 628 B SEVENTH ST | ||||||||
| Address2: | |||||||||
| City: | LANAI CITY | ||||||||
| State: | HI | ||||||||
| PostalCode: | 96763 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085656423 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | OKABE | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO, SR., VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8085357202 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336C0002X | Y | Suppliers | Pharmacy | Clinic Pharmacy |
No ID Information.