Provider Demographics
NPI:1285852046
Name:KAHUKU HOSPITAL
Entity Type:Organization
Organization Name:KAHUKU HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANY
Authorized Official - Middle Name:
Authorized Official - Last Name:VAIOLETI
Authorized Official - Suffix:
Authorized Official - Credentials:LSW, JURISD
Authorized Official - Phone:808-293-9221
Mailing Address - Street 1:56-117 PUALALEA ST
Mailing Address - Street 2:
Mailing Address - City:KAHUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96731-2052
Mailing Address - Country:US
Mailing Address - Phone:808-293-9221
Mailing Address - Fax:808-232-0197
Practice Address - Street 1:56-117 PUALALEA ST
Practice Address - Street 2:
Practice Address - City:KAHUKU
Practice Address - State:HI
Practice Address - Zip Code:96731-2052
Practice Address - Country:US
Practice Address - Phone:808-293-9221
Practice Address - Fax:808-232-0197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH0000WCCGSMedicare ID - Type UnspecifiedGROUP PROVIDER NUMBER