Provider Demographics
NPI:1366486979
Name:MOLOKAI GENERAL HOSPITAL
Entity Type:Organization
Organization Name:MOLOKAI GENERAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:KALANIHUIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-553-3123
Mailing Address - Street 1:PO BOX 408
Mailing Address - Street 2:
Mailing Address - City:KAUNAKAKAI
Mailing Address - State:HI
Mailing Address - Zip Code:96748-0408
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:280 HOMEOLU PLACE
Practice Address - Street 2:
Practice Address - City:KAUNAKAKAI
Practice Address - State:HI
Practice Address - Zip Code:96748
Practice Address - Country:US
Practice Address - Phone:808-553-5331
Practice Address - Fax:808-553-3133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI34-N/18-H282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00245201Medicaid
HI125034Medicare Oscar/Certification
HI00245201Medicaid
HI0000WCCGVMedicare ID - Type UnspecifiedPART B
HI121303Medicare ID - Type Unspecified
HI12Z303Medicare Oscar/Certification