Individual provider Active NPI

Kim Tien Nguyen, PHARM D

  • Pharmacist
  • Wailuku, HI
National Provider Identifier
1306128467
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH-3461 Issued in HI
Practice address
135 Kehalani Village Dr
Wailuku, HI 96793-2197
Phone
(808) 242-5606
NPI assigned
Sep 15, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH-3461 HI Primary

Addresses

Primary practice location

135 Kehalani Village Dr
Wailuku, HI 96793-2197

Mailing address

135 Kehalani Village Dr
Wailuku, HI 96793-2197
Phone (808) 242-5606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH-3461HIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rockhill Pharmacy, LLC Past Accepting new patients
Longs Drug Stores California LLC PastSince Dec 21, 2025 Accepting new patients
Longs Drug Store California LLC PastSince Dec 21, 2025 Accepting new patients
Rockhill Pharmacy, LLC Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1306128467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 KEHALANI VILLAGE DR",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932197",
            "telephone_number": "808-242-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 KEHALANI VILLAGE DR",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932197",
            "telephone_number": "808-242-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KIM TIEN",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-15",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "HI",
            "license": "PH-3461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.