Provider Demographics
NPI:1114637410
Name:LEAHI HOSPITAL
Entity Type:Organization
Organization Name:LEAHI HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMAMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-832-6147
Mailing Address - Street 1:3675 KILAUEA AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-2398
Mailing Address - Country:US
Mailing Address - Phone:808-832-6147
Mailing Address - Fax:808-733-9806
Practice Address - Street 1:3675 KILAUEA AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-2398
Practice Address - Country:US
Practice Address - Phone:808-832-6147
Practice Address - Fax:808-733-9806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI003145Medicaid