Provider Demographics
NPI:1114036894
Name:REHABILITATION HOSPITAL OF THE PACIFIC
Entity Type:Organization
Organization Name:REHABILITATION HOSPITAL OF THE PACIFIC
Other - Org Name:REHAB AT MAUI - KIHEI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE & CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:SUE ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORIWAKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-566-3818
Mailing Address - Street 1:226 N KUAKINI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2421
Mailing Address - Country:US
Mailing Address - Phone:808-531-3511
Mailing Address - Fax:808-544-3377
Practice Address - Street 1:221 PIIKEA AVE
Practice Address - Street 2:SUITE D
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8268
Practice Address - Country:US
Practice Address - Phone:808-879-5211
Practice Address - Fax:808-879-5213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
144692908OtherOWCP
HI51997801Medicaid
00S0208559OtherALL HMSA PLANS
96753B001OtherCHAMPUS
144692908OtherOWCP