Provider Demographics
NPI:1477756245
Name:HAWAII HEALTH SYSTEMS CORPORATION
Entity Type:Organization
Organization Name:HAWAII HEALTH SYSTEMS CORPORATION
Other - Org Name:YUKIO OKUTSU STATE VETERAN'S HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRES. POLICY & GOV. RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINCOLN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-325-0153
Mailing Address - Street 1:1180 WAIANUENUE AVE
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2020
Mailing Address - Country:US
Mailing Address - Phone:808-961-1500
Mailing Address - Fax:808-933-1835
Practice Address - Street 1:1180 WAIANUENUE AVE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2020
Practice Address - Country:US
Practice Address - Phone:801-325-0153
Practice Address - Fax:801-496-8844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI125058OtherLEGACY/PTAN
UT125058Medicare Oscar/Certification