Provider Demographics
NPI:1336208446
Name:QUEEN'S DEVELOPMENT CORPORATION & SUBSIDIARIES
Entity Type:Organization
Organization Name:QUEEN'S DEVELOPMENT CORPORATION & SUBSIDIARIES
Other - Org Name:THE QUEEN'S HEALTH CARE CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHINEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-547-4600
Mailing Address - Street 1:1099 ALAKEA ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4511
Mailing Address - Country:US
Mailing Address - Phone:808-547-4600
Mailing Address - Fax:808-547-4559
Practice Address - Street 1:1099 ALAKEA ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4511
Practice Address - Country:US
Practice Address - Phone:808-547-4600
Practice Address - Fax:808-547-4559
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUEEN'S DEVELOPMENT CORPORATION & SUBSIDIARIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-06
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI52655Medicare ID - Type UnspecifiedGROUP NUMBER