Healthcare Provider Details

I. General information

NPI: 1366383796
Provider Name (Legal Business Name): IRIS JI HYUN KIM MIWA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 475 BOX 1
FPO AP
96350-1200
US

IV. Provider business mailing address

PSC 451 BOX 336
FPO AP
96346-0004
US

V. Phone/Fax

Practice location:
  • Phone: 46-816-7144
  • Fax:
Mailing address:
  • Phone: 46-816-7144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH3084
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: