Basic Information
Provider Information
NPI: 1821233800
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FURUTANI
FirstName: BRETT
MiddleName: CHRIS
NamePrefix: DR.
NameSuffix:  
Credential: PHARMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1810 HALEOKEA ST
Address2:  
City: HILO
State: HI
PostalCode: 967205947
CountryCode: US
TelephoneNumber: 8089596456
FaxNumber:  
Practice Location
Address1: 555 KILAUEA AVE
Address2:  
City: HILO
State: HI
PostalCode: 967203011
CountryCode: US
TelephoneNumber: 8089359075
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/05/2008
LastUpdateDate: 12/05/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X2798HIY Pharmacy Service ProvidersPharmacist 

No ID Information.


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