Provider Demographics
NPI:1215349527
Name:YONGVANICH, ROSEMARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:YONGVANICH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75-184 HUALALAI RD
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-1719
Mailing Address - Country:US
Mailing Address - Phone:408-334-4437
Mailing Address - Fax:
Practice Address - Street 1:75-184 HUALALAI RD
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1719
Practice Address - Country:US
Practice Address - Phone:808-334-4437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-2139183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist