Provider Demographics
NPI:1780996579
Name:RAINBOW PHARMACY, LLC
Entity type:Organization
Organization Name:RAINBOW PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:KERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, MT
Authorized Official - Phone:808-879-9924
Mailing Address - Street 1:2349 S KIHEI RD
Mailing Address - Street 2:#4
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2349 S KIHEI RD
Practice Address - Street 2:#4
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7202
Practice Address - Country:US
Practice Address - Phone:808-879-9924
Practice Address - Fax:808-879-9925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPHY7863336S0011X, 3336L0003X
HIPHY-786333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy