Provider Demographics
NPI:1821099680
Name:HAWAIIAN ISLANDS MEDICAL CORP
Entity Type:Organization
Organization Name:HAWAIIAN ISLANDS MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:M
Authorized Official - Last Name:STEELQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-597-8087
Mailing Address - Street 1:841 POHUKAINA ST
Mailing Address - Street 2:#8
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5332
Mailing Address - Country:US
Mailing Address - Phone:808-597-8087
Mailing Address - Fax:808-597-8474
Practice Address - Street 1:841 POHUKAINA ST
Practice Address - Street 2:#8
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5332
Practice Address - Country:US
Practice Address - Phone:808-597-8087
Practice Address - Fax:808-597-8474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI520032 01Medicaid
HI4154030001Medicare ID - Type Unspecified