Provider Demographics
NPI:1033602743
Name:QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:QUEEN'S NORTH HAWAII COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERLYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:TABAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-881-4626
Mailing Address - Street 1:67-1125 MAMALAHOA HWY
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-8496
Mailing Address - Country:US
Mailing Address - Phone:808-885-9606
Mailing Address - Fax:
Practice Address - Street 1:67-1125 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8496
Practice Address - Country:US
Practice Address - Phone:808-885-9606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-08
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty