Provider Demographics
NPI:1285935312
Name:FURUTANI, REID
Entity type:Individual
Prefix:
First Name:REID
Middle Name:
Last Name:FURUTANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAMAKUA DR
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3985
Mailing Address - Country:US
Mailing Address - Phone:808-266-5220
Mailing Address - Fax:808-266-5213
Practice Address - Street 1:200 HAMAKUA DR
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-3985
Practice Address - Country:US
Practice Address - Phone:808-266-5220
Practice Address - Fax:808-266-5213
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2407183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist