Provider Demographics
NPI:1952508921
Name:PALI MOMI MEDICAL CENTER
Entity Type:Organization
Organization Name:PALI MOMI MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO, SR. VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:OKABE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-535-7202
Mailing Address - Street 1:1946 YOUNG ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-2169
Mailing Address - Country:US
Mailing Address - Phone:808-973-7320
Mailing Address - Fax:808-973-7325
Practice Address - Street 1:98-1079 MOANALUA RD
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4713
Practice Address - Country:US
Practice Address - Phone:808-486-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAPIOLANI MEDICAL CENTER AT PALI MOMI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-02
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1202631OtherNCPDP