Provider Demographics
NPI:1366680597
Name:STATE OF HAWAII DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:STATE OF HAWAII DEPARTMENT OF HEALTH
Other - Org Name:KONA COMMUNITY HOSPITAL- PROFESSIONAL SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:FINANCIAL RESOURCE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NAKAHARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-590-7320
Mailing Address - Street 1:PO BOX 3378
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96801-3378
Mailing Address - Country:US
Mailing Address - Phone:808-590-7320
Mailing Address - Fax:808-586-4745
Practice Address - Street 1:79-1019 HAUKAPILA ST
Practice Address - Street 2:
Practice Address - City:KEALAKEKUA
Practice Address - State:HI
Practice Address - Zip Code:96750-7920
Practice Address - Country:US
Practice Address - Phone:808-322-4818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-26
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital