Provider Demographics
NPI:1619238607
Name:STRAUB CLINIC & HOSPITAL
Entity Type:Organization
Organization Name:STRAUB CLINIC & HOSPITAL
Other - Org Name:STRAUB MEDICAL CENTER OUTPATIENT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP & CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:Y
Authorized Official - Last Name:OKABE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-535-7202
Mailing Address - Street 1:888 SOUTH KING STREET
Mailing Address - Street 2:ROTUNDA SUITE 100
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3097
Mailing Address - Country:US
Mailing Address - Phone:808-840-5640
Mailing Address - Fax:808-537-5155
Practice Address - Street 1:888 SOUTH KING ST, ROTUNDA SUITE 100
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813
Practice Address - Country:US
Practice Address - Phone:808-840-5640
Practice Address - Fax:808-537-5155
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STRAUB CLINIC & HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-06
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2135363OtherPK
HI574188Medicaid
4309320003Medicare NSC