Provider Demographics
NPI:1780131730
Name:GIACOBBI, PHILLIP (PHARMD RPH)
Entity type:Individual
Prefix:
First Name:PHILLIP
Middle Name:
Last Name:GIACOBBI
Suffix:
Gender:M
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 1:1964 UHALOA RD
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-1431
Mailing Address - Country:US
Mailing Address - Phone:808-462-1477
Mailing Address - Fax:
Practice Address - Street 1:1964 UHALOA RD
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-1431
Practice Address - Country:US
Practice Address - Phone:808-462-1477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH3030183500000X
PARP444071183500000X
AZS016365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist