Provider Demographics
NPI:1366723538
Name:ROBUSTO, WILLIAM RICHARD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RICHARD
Last Name:ROBUSTO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 KAHILI PL
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-1119
Mailing Address - Country:US
Mailing Address - Phone:808-667-9187
Mailing Address - Fax:808-667-9521
Practice Address - Street 1:342 KEAWE ST
Practice Address - Street 2:
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-2739
Practice Address - Country:US
Practice Address - Phone:808-667-9515
Practice Address - Fax:808-667-9521
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2109183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist