Provider Demographics
NPI:1730710419
Name:MASON, AMI (RPH)
Entity type:Individual
Prefix:
First Name:AMI
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 LIMAHANA CIR # C202
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-2437
Mailing Address - Country:US
Mailing Address - Phone:215-888-3747
Mailing Address - Fax:808-661-4240
Practice Address - Street 1:1221 HONOAPIILANI HWY
Practice Address - Street 2:
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-1796
Practice Address - Country:US
Practice Address - Phone:808-667-4390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist