Provider Demographics
NPI:1164083374
Name:KAU HOSPITAL
Entity Type:Organization
Organization Name:KAU HOSPITAL
Other - Org Name:EAST HAWAII HEALTH CLINIC AT PUUHONU WAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL RHC ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURI
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:REDUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-932-3801
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:PAHALA
Mailing Address - State:HI
Mailing Address - Zip Code:96777-0040
Mailing Address - Country:US
Mailing Address - Phone:808-932-3801
Mailing Address - Fax:808-935-1889
Practice Address - Street 1:1285 WAIANUENUE AVE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-1209
Practice Address - Country:US
Practice Address - Phone:808-932-3940
Practice Address - Fax:808-933-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-27
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty