Provider Demographics
NPI:1144328170
Name:QSI INC
Entity type:Organization
Organization Name:QSI INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJIA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:808-832-8255
Mailing Address - Street 1:PO BOX 29960
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96820-2360
Mailing Address - Country:US
Mailing Address - Phone:808-832-8265
Mailing Address - Fax:808-832-8268
Practice Address - Street 1:98 1264 KAAHUMANU ST
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782
Practice Address - Country:US
Practice Address - Phone:808-483-3078
Practice Address - Fax:808-483-3086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
HIPHY6293336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI08474301Medicaid
2018164OtherPK
HI1201944Medicaid
HI08474301Medicaid
HI1144328170OtherNPI