Organization

Puna Plantation Hawaii, Ltd.

May also be knows as Kta Keauhou Pharmacy

Community/Retail Pharmacy in Kailua Kona, HI(View on Map)

Legal Business Name

Puna Plantation Hawaii, Ltd.

Also Known As

Kta Keauhou Pharmacy

NPI Number

1518057017

NPI Type

Organization

Enumeration Date

10/13/2006

Specialties

(Taxonomies)

Code

3336C0003X

Primary Taxonomy

Yes

Licenses

State

Hawaii

License Number

PHY349

Contact
Information

Purpose

Mailing
Location

Address

78-6831 ALII DR
78-6831 ALII DR

City

Kailua Kona
Kailua Kona

State

HI
HI

Postal Code

96740-2495
96740-2495

Country

US
US

Telephone Number

(808) 322-2511
(808) 322-2511

Authorized Official

Name

Toby Taniguchi

Title or Position

PRESIDENT

Telephone Number

(808) 989-5466

Identifiers

Identifier

102639
08387401

Identifier State

HI
HI

Identifier Issuer

MEDICARE MASS IMMUNIZ ROS
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 12/11/2023

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