Provider Demographics
NPI:1861710022
Name:TAGARIELLO, PHILIP ANDREW (PHARM D)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:ANDREW
Last Name:TAGARIELLO
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 OKOA ST
Mailing Address - Street 2:T-2410
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-2647
Mailing Address - Country:US
Mailing Address - Phone:808-224-5575
Mailing Address - Fax:
Practice Address - Street 1:4380 LAWEHANA ST
Practice Address - Street 2:T-2410
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818-3137
Practice Address - Country:US
Practice Address - Phone:808-441-3119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1787183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist