Organization
MEDIPHARM PHARMACY LLC
Active
Other names
MEDIPHARM PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT KIM (PHRM)
(808) 523-7088
Entity
Organization
Contact information
Practice address
197 SAND ISLAND ACCESS RD STE 208, HONOLULU, HI 96819-4901
(808) 744-9080
(808) 744-9079
Mailing address
PO BOX 38029, HONOLULU, HI 96837-1029
(808) 791-6077
(808) 791-6076
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY689
HI
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1239929
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
592495
—
HI
Enumeration date
03/23/2007
Last updated
08/15/2023
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