Organization Active NPI

5 Minute Pharmacy LLC

  • Community/Retail Pharmacy
  • Waipahu, HI
National Provider Identifier
1588988257
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY-783 Issued in HI
Legal business name
5 MINUTE PHARMACY LLC
Doing business as
5 Minute Pharmacy, LLC
Practice address
94-216 Farrington Hwy Ste B1-102
Waipahu, HI 96797-1922
Phone
(808) 677-5550
Fax
(808) 677-5553
NPI assigned
Mar 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Authorized official

Name
Jill Tengan, PHARMD
Title
Member
Phone
(808) 677-5550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY-783 HI Primary

Addresses

Primary practice location

94-216 Farrington Hwy Ste B1-102
Waipahu, HI 96797-1922

Mailing address

94-216 Farrington Hwy Ste 102
Waipahu, HI 96797-1900
Phone (808) 677-5550

Other identifiers 2

IdentifierTypeStateIssuer
642951-01MedicaidHI
2124939OtherPK

Other names 1

  • 5 Minute Pharmacy, LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110113000839 HI Part B Supplier - Mass Immunization (Roster Biller Only) 3678762101 Practice locations: Waipahu, HI
O20241001003937 HI Part B Supplier - Pharmacy 3678762101 Practice locations: Waipahu, HI

National Provider Directory

National Provider Directory

Locations

916 Gulick Ave
Ste A
Honolulu, HI 96819
Phone (808) 845-5550

94-216 Farrington Hwy
Ste 102
Waipahu, HI 96797
Phone (808) 630-8388

94-216 Farrington Hwy
Waipahu, HI 96797
Phone (808) 383-8643

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387411200000",
    "number": "1588988257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-216 FARRINGTON HWY STE 102",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967971900",
            "telephone_number": "808-677-5550",
            "fax_number": "808-677-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-216 FARRINGTON HWY STE B1-102",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967971922",
            "telephone_number": "808-677-5550",
            "fax_number": "808-677-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "5 MINUTE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-24",
        "last_updated": "2013-12-19",
        "status": "A",
        "authorized_official_last_name": "TENGAN",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "808-677-5550",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "HI",
            "license": "PHY-783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "642951-01",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2124939",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "5 Minute Pharmacy, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waipahu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.