| Organization Name: | KO'OLAULOA COMMUNITY HEALTH AND WELLNESS CENTER |
| NPI Number: | 1235442849 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHRISTOPHER N TSUE (DIRECTOR OF PHARMACY) |
| Mailing Address: | 56-119 Pualalea St Kahuku |
| State: | HI US |
| Postal Code: | 967312052 |
| Phone Number: | 8082939514 |
| Fax Number: | |
| NPI Enumeration Date: | 07/23/2010 |
| NPI Last Update Date: | 12/31/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336C0002X |
| License Number: | PHY788 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | HI |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Clinic Pharmacy |
| Taxonomy Definition: | A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |