Provider Demographics
NPI:1164782611
Name:R WEINSTEIN IMMUNIZATION & PRESCRIPTION SERVICES LLC
Entity Type:Organization
Organization Name:R WEINSTEIN IMMUNIZATION & PRESCRIPTION SERVICES LLC
Other - Org Name:WEINSTEIN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIDO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:808-312-3437
Mailing Address - Street 1:846 POHUKAINA ST STE F
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5300
Mailing Address - Country:US
Mailing Address - Phone:808-312-3437
Mailing Address - Fax:808-312-3441
Practice Address - Street 1:846 POHUKAINA ST # F
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5300
Practice Address - Country:US
Practice Address - Phone:808-312-3437
Practice Address - Fax:808-312-3441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
HIPHY8183336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2135261OtherPK