Provider Demographics
NPI:1255923918
Name:PELLEGRINI, JILL MARIE (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:MARIE
Last Name:PELLEGRINI
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2970 KELE ST STE 113
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1822
Mailing Address - Country:US
Mailing Address - Phone:808-245-8042
Mailing Address - Fax:
Practice Address - Street 1:2970 KELE ST STE 113
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1822
Practice Address - Country:US
Practice Address - Phone:808-245-8042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH4598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist