Provider Demographics
NPI:1851389365
Name:THE QUEENS MEDICAL CENTER - PROGRESSIVE CARE UNIT
Entity Type:Organization
Organization Name:THE QUEENS MEDICAL CENTER - PROGRESSIVE CARE UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT & CAO
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOSHIOKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-537-7996
Mailing Address - Street 1:1301 PUNCHBOWL ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2402
Mailing Address - Country:US
Mailing Address - Phone:808-538-9011
Mailing Address - Fax:
Practice Address - Street 1:1301 PUNCHBOWL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2402
Practice Address - Country:US
Practice Address - Phone:808-538-9011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI31-N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0020OtherTRICARE SNF
HIB2469-1OtherHMSA SNF
HIM4091-7OtherHMSA QUEST PCU/SNF R&B
HI125037OtherHMSA 65C SNF
HIL4091-0OtherHMSA QUEST PCU/SNF ANC
HIL4091-0OtherHMSA QUEST PCU/SNF ANC