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NPI Code Detail

MEDICARE: ANDREW AGUSTIN PHARMD

MEDICARE: ANDREW AGUSTIN PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPH-4504HI

General Provider Information

NPI Number : 1003453705
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW AGUSTIN PHARMD
Provider Business Mailing Address
First Line : 91-2012 LAAKONA PL
Second Line :
City : EWA BEACH
State : HI
Zip : 96706-4020
Country : US
Telephone Number : 808-392-5666
Fax Number :
Provider Business Practice Location Address
First Line : 1131 KUALA ST
Second Line :
City : PEARL CITY
State : HI
Zip : 96782-2886
Country : US
Telephone Number : 808-454-8792
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2019
Last Update Date : 09/22/2020

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