Provider Demographics
NPI:1306386222
Name:RAWAL, SHREEYESH (RPH)
Entity Type:Individual
Prefix:
First Name:SHREEYESH
Middle Name:
Last Name:RAWAL
Suffix:
Gender:M
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:PO BOX 3926
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-6926
Mailing Address - Country:US
Mailing Address - Phone:808-245-8042
Mailing Address - Fax:
Practice Address - Street 1:2970 KELE ST
Practice Address - Street 2:SUITE 113A
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1823
Practice Address - Country:US
Practice Address - Phone:808-245-8042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH3018183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist