Provider Demographics
NPI:1467510743
Name:KAUAI VETERANS MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:KAUAI VETERANS MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ASATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-338-9407
Mailing Address - Street 1:PO BOX 337
Mailing Address - Street 2:
Mailing Address - City:WAIMEA
Mailing Address - State:HI
Mailing Address - Zip Code:96896-0337
Mailing Address - Country:US
Mailing Address - Phone:808-338-9431
Mailing Address - Fax:808-338-9420
Practice Address - Street 1:4643 WAIMEA CANYON DRIVE
Practice Address - Street 2:
Practice Address - City:WAIMEA
Practice Address - State:HI
Practice Address - Zip Code:96796-0337
Practice Address - Country:US
Practice Address - Phone:808-338-9431
Practice Address - Fax:808-338-9420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI21-H282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI508145Medicaid
HI121300Medicare PIN