Provider Demographics
NPI:1639217300
Name:HAWAII HEALTH SYSTEMS CORP
Entity Type:Organization
Organization Name:HAWAII HEALTH SYSTEMS CORP
Other - Org Name:KONA COMMUNITY HOSPITAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARLINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PASSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-322-9311
Mailing Address - Street 1:79 1019 HAUKAPILA ST
Mailing Address - Street 2:
Mailing Address - City:KEALAKEKUA
Mailing Address - State:HI
Mailing Address - Zip Code:96750
Mailing Address - Country:US
Mailing Address - Phone:808-322-4470
Mailing Address - Fax:808-322-4599
Practice Address - Street 1:79 1019 HAUKAPILA ST
Practice Address - Street 2:
Practice Address - City:KEALAKEKUA
Practice Address - State:HI
Practice Address - Zip Code:96750
Practice Address - Country:US
Practice Address - Phone:808-322-4470
Practice Address - Fax:808-322-4599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336I0012X
HIPHY-2263336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI05157Medicaid
HI00577401Medicaid
2018907OtherPK
1204077OtherOTHER ID NUMBER