Provider Demographics
NPI:1659501096
Name:LANAI COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:LANAI COMMUNITY HOSPITAL
Other - Org Name:LANAI COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:
Authorized Official - Last Name:STARBIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-242-2648
Mailing Address - Street 1:PO BOX 630650
Mailing Address - Street 2:
Mailing Address - City:LANAI CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96763-0650
Mailing Address - Country:US
Mailing Address - Phone:808-565-8450
Mailing Address - Fax:808-565-8474
Practice Address - Street 1:628 SEVENTH ST
Practice Address - Street 2:
Practice Address - City:LANAI CITY
Practice Address - State:HI
Practice Address - Zip Code:96763
Practice Address - Country:US
Practice Address - Phone:808-565-8450
Practice Address - Fax:808-565-8474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIE005873336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2019426OtherPK
HI00251877Medicaid