Provider Demographics
NPI:1831500024
Name:WILKIN, RYAN P (PHARMD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:P
Last Name:WILKIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3740 LOWER HONOAPIILANI RD
Mailing Address - Street 2:E105
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-8900
Mailing Address - Country:US
Mailing Address - Phone:808-269-5638
Mailing Address - Fax:808-661-8002
Practice Address - Street 1:3350 LOWER HONOAPIILANI RD
Practice Address - Street 2:E105
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-8402
Practice Address - Country:US
Practice Address - Phone:808-661-8008
Practice Address - Fax:808-661-8008
Is Sole Proprietor?:No
Enumeration Date:2014-05-11
Last Update Date:2014-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-3431183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist