Provider Demographics
NPI:1609498682
Name:THE QUEEN'S MEDICAL CENTER
Entity Type:Organization
Organization Name:THE QUEEN'S MEDICAL CENTER
Other - Org Name:THE QUEEN'S HEALTH CARE CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-691-7744
Mailing Address - Street 1:PO BOX 29640
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96820-2040
Mailing Address - Country:US
Mailing Address - Phone:808-691-5027
Mailing Address - Fax:
Practice Address - Street 1:1215 HUNAKAI ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-4661
Practice Address - Country:US
Practice Address - Phone:808-686-4200
Practice Address - Fax:808-735-7003
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE QUEEN'S MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-12
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service