Provider Demographics
NPI:1912541905
Name:THE QUEENS MEDICAL CENTER
Entity Type:Organization
Organization Name:THE QUEENS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT TREASURER, THE QUEENS MED
Authorized Official - Prefix:
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-691-4600
Mailing Address - Street 1:1301 PUNCHBOWL STREET
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813
Mailing Address - Country:US
Mailing Address - Phone:808-691-4600
Mailing Address - Fax:808-691-4559
Practice Address - Street 1:98-199 KAMEHAMEHA HWY
Practice Address - Street 2:SUITE F
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701
Practice Address - Country:US
Practice Address - Phone:808-735-0007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE QUEENS MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care