Provider Demographics
NPI:1023127750
Name:REHABILITATION HOSPITAL OF THE PACIFIC
Entity type:Organization
Organization Name:REHABILITATION HOSPITAL OF THE PACIFIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR VICE PRESIDENT & CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-566-3818
Mailing Address - Street 1:226 N KUAKINI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2421
Mailing Address - Country:US
Mailing Address - Phone:808-531-3511
Mailing Address - Fax:808-544-3377
Practice Address - Street 1:75-1029 HENRY ST
Practice Address - Street 2:SUITE 101
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1666
Practice Address - Country:US
Practice Address - Phone:808-334-0806
Practice Address - Fax:808-334-0483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
00H0208556OtherALL HMSA PLANS
96740A001OtherCHAMPUS
144692907OtherOWCP
HI51992801Medicaid