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General NPI Number Information
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NPI Number | 1306184981
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Entity Type | Individual
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Provider Name | JEAN MARIE RILEY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/16/2013
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 101 PAKAULA ST
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City | KAHULUI
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State | HI
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Zip | 96732-3508
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Country | US
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Telephone | 808-871-7012
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Fax |
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Provider Business Mailing Address
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Address Line | 101 PAKAULA ST
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City | KAHULUI
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State | HI
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Zip | 96732-3508
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Country | US
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Telephone | 808-871-7012
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS42618
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH4164
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License Number State | HI
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