Provider Demographics
NPI:1942550173
Name:KONA HOSPITAL
Entity Type:Organization
Organization Name:KONA HOSPITAL
Other - Org Name:KONA COMMUNITY HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:REGIONAL CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:KREUZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-322-4433
Mailing Address - Street 1:79-1019 HAUKAPILA ST
Mailing Address - Street 2:
Mailing Address - City:KEALAKEKUA
Mailing Address - State:HI
Mailing Address - Zip Code:96750-7920
Mailing Address - Country:US
Mailing Address - Phone:808-322-9311
Mailing Address - Fax:808-322-0855
Practice Address - Street 1:79-1019 HAUKAPILA ST
Practice Address - Street 2:
Practice Address - City:KEALAKEKUA
Practice Address - State:HI
Practice Address - Zip Code:96750-7920
Practice Address - Country:US
Practice Address - Phone:808-322-9311
Practice Address - Fax:808-322-0855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI45-N275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI12U019Medicare Oscar/Certification