Provider Demographics
NPI:1639531924
Name:KIM, JIN HEE (PHARM D)
Entity Type:Individual
Prefix:
First Name:JIN HEE
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 S KING ST STE 203A
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2568
Mailing Address - Country:US
Mailing Address - Phone:808-228-1344
Mailing Address - Fax:808-379-2357
Practice Address - Street 1:1451 S KING ST STE 203A
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2568
Practice Address - Country:US
Practice Address - Phone:808-379-2347
Practice Address - Fax:808-379-2357
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI060517-1183500000X
HIPH-4433183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI001097Medicaid