Provider Demographics
NPI:1467876482
Name:5 MINUTE PHARMACY SPECIALTY, LLC
Entity Type:Organization
Organization Name:5 MINUTE PHARMACY SPECIALTY, LLC
Other - Org Name:5 MINUTE PHARMACY SPECIALTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:M
Authorized Official - Last Name:TENGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-848-5511
Mailing Address - Street 1:94-216 FARRINGTON HWY
Mailing Address - Street 2:#102
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-1922
Mailing Address - Country:US
Mailing Address - Phone:808-848-5511
Mailing Address - Fax:808-848-5577
Practice Address - Street 1:94-216 FARRINGTON HWY
Practice Address - Street 2:SUITE #B1-102C
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-1922
Practice Address - Country:US
Practice Address - Phone:808-848-5511
Practice Address - Fax:808-848-5577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy