NPIMap

Organization Active NPI

Medipharm Pharmacy LLC

Doing business as Medipharm Pharmacy

  • Long Term Care Pharmacy
  • Honolulu, HI
National Provider Identifier
1912024209
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
MEDIPHARM PHARMACY LLC
Doing business as
Medipharm Pharmacy
Practice address
197 Sand Island Access Rd Ste 208
Honolulu, HI 96819-4901
Phone
(808) 744-9080
Fax
(808) 744-9079
NPI assigned
Mar 23, 2007
Last updated
Aug 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Authorized official

Name
Scott KimNPI 1184214959
Title
PHRM
Phone
(808) 523-7088

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHY689 HI
Community/Retail Pharmacy 3336C0003X NU
Long Term Care Pharmacy 3336L0003X NU Primary

Addresses

Primary practice location

197 Sand Island Access Rd Ste 208
Honolulu, HI 96819-4901

Mailing address

PO Box 38029
Honolulu, HI 96837-1029
Phone (808) 791-6077

Other identifiers 2

IdentifierTypeStateIssuer
1239929OtherNCPDP PROVIDER IDENTIFICATION NUMBER
592495MedicaidHI

Other names 1

  • MEDIPHARM PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medipharm Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

197 Sand Island Access Rd
Ste 208
Honolulu, HI 96819
Phone (808) 744-9080

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1912024209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38029",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968371029",
            "telephone_number": "808-791-6077",
            "fax_number": "808-791-6076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 SAND ISLAND ACCESS RD STE 208",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968194901",
            "telephone_number": "808-744-9080",
            "fax_number": "808-744-9079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIPHARM PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PHRM",
        "authorized_official_telephone_number": "808-523-7088"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "HI",
            "license": "PHY689",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1239929",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "592495",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDIPHARM PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEDIPHARM PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.