Provider Demographics
NPI:1265428510
Name:NORTH HAWAII HOSPICE INC
Entity type:Organization
Organization Name:NORTH HAWAII HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-885-7547
Mailing Address - Street 1:65-1328 KAWAIHAE RD
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-8448
Mailing Address - Country:US
Mailing Address - Phone:808-885-7547
Mailing Address - Fax:808-885-5592
Practice Address - Street 1:65-1328 KAWAIHAE RD
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8448
Practice Address - Country:US
Practice Address - Phone:808-885-7547
Practice Address - Fax:808-885-5592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI005835OtherHMSA QUEST
HI053382OtherMEDICAID
HI0583-5OtherHMSA
HI0583-5OtherHMSA FED
HI=========OtherHMA
HI=========OtherKAPIOLANI HEALTH
HI=========OtherTRICARE/CHAMPUS
HI005835OtherHMSA QUEST
HI053382OtherMEDICAID
HI0583-5OtherHMSA FED
HI0583-5OtherHMSA
HI=========OtherUHA
HI121506Medicare ID - Type UnspecifiedMEDICARE