Provider Demographics
NPI:1487047213
Name:5 MINUTE PHARMACY ALA MOANA LLC
Entity type:Organization
Organization Name:5 MINUTE PHARMACY ALA MOANA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:TENGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-630-8388
Mailing Address - Street 1:1441 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 806
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4402
Mailing Address - Country:US
Mailing Address - Phone:808-797-2905
Mailing Address - Fax:855-382-0230
Practice Address - Street 1:1441 KAPIOLANI BLVD
Practice Address - Street 2:STE 806
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4402
Practice Address - Country:US
Practice Address - Phone:808-797-2905
Practice Address - Fax:855-382-0230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy