Provider Demographics
NPI:1396727384
Name:HODGES, SAMUEL CLAY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:CLAY
Last Name:HODGES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 ALA MOANA BLVD STE 1D
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4902
Mailing Address - Country:US
Mailing Address - Phone:808-587-6630
Mailing Address - Fax:
Practice Address - Street 1:500 ALA MOANA BLVD STE 1D
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813
Practice Address - Country:US
Practice Address - Phone:808-587-6630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50922183500000X
HIPH-2311183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist