Provider Demographics
NPI:1639886039
Name:SU, KIMBERLY K (PHARMD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:K
Last Name:SU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:K
Other - Last Name:DOI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:321 N KUAKINI ST #105
Mailing Address - Street 2:PLAZA PHARMACY
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:321 N KUAKINI ST #105
Practice Address - Street 2:PLAZA PHARMACY
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817
Practice Address - Country:US
Practice Address - Phone:808-547-9440
Practice Address - Fax:808-547-9434
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-1815183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist