Provider Demographics
NPI:1518741487
Name:THE QUEEN'S MEDICAL CENTER
Entity Type:Organization
Organization Name:THE QUEEN'S MEDICAL CENTER
Other - Org Name:THE QUEEN'S MEDICAL CENTER -OUTPATIENT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AMC PRESIDENT (THE QUEEN'S MEDICAL
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRUNO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-691-4153
Mailing Address - Street 1:1301 PUNCHBOWL ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2499
Mailing Address - Country:US
Mailing Address - Phone:808-691-4407
Mailing Address - Fax:808-691-4098
Practice Address - Street 1:1301 PUNCHBOWL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2499
Practice Address - Country:US
Practice Address - Phone:808-691-7265
Practice Address - Fax:808-691-7845
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE QUEEN'S MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-22
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy