Provider Demographics
NPI:1710405402
Name:EBBETT, RACHEL ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ANN
Last Name:EBBETT
Suffix:
Gender:F
Credentials:PHARMD
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 3235
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-6235
Mailing Address - Country:US
Mailing Address - Phone:209-402-3785
Mailing Address - Fax:
Practice Address - Street 1:4491 KOLOPA ST # A
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-2021
Practice Address - Country:US
Practice Address - Phone:808-246-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2017-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI4114183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist