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General NPI Number Information
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NPI Number | 1104573088
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Entity Type | Organization
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Legal Business Name | 5 MINUTE PHARMACY LTC LLC
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Dates
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Enumeration Date | 03/09/2022
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 94-449 AKOKI ST STE 102
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City | WAIPAHU
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State | HI
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Zip | 96797-2732
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Country | US
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Telephone | 808-671-5511
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Fax | 808-671-5522
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Provider Business Mailing Address
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Address Line | 94-449 AKOKI ST STE 102
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City | WAIPAHU
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State | HI
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Zip | 96797-2732
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Country | US
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Telephone | 808-671-5511
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Fax | 808-671-5522
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Authorized Official
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Title or Position | MEMBER
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Name | DEREK TENGAN
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Credential | PHARM.D.
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Telephone | 808-671-5511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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