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NPI Code Detail

MEDICARE: DR. RICHARD EDWARD SHIELDS PHARM.D.

MEDICARE: DR. RICHARD EDWARD SHIELDS PHARM.D.
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
11835X0200XOncology PharmacistPH-2497HI

General Provider Information

NPI Number : 1477556124
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD EDWARD SHIELDS PHARM.D.
Provider Business Mailing Address
First Line : 1441 VICTORIA ST APT 403
Second Line :
City : HONOLULU
State : HI
Zip : 96822-3669
Country : US
Telephone Number : 808-372-1140
Fax Number :
Provider Business Practice Location Address
First Line : 3288 MOANALUA RD
Second Line : KAISER PERMANENTE HAWAII
City : HONOLULU
State : HI
Zip : 96819
Country : US
Telephone Number : 808-432-8593
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 11/22/2013

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