Provider Demographics
NPI:1356423974
Name:LANAI COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:LANAI COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRAITOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAUMBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-565-6411
Mailing Address - Street 1:628 SEVENTH STREET
Mailing Address - Street 2:
Mailing Address - City:LANAI
Mailing Address - State:HI
Mailing Address - Zip Code:96763
Mailing Address - Country:US
Mailing Address - Phone:808-565-6411
Mailing Address - Fax:
Practice Address - Street 1:628 SEVENTH STREET
Practice Address - Street 2:
Practice Address - City:LANAI
Practice Address - State:HI
Practice Address - Zip Code:96763
Practice Address - Country:US
Practice Address - Phone:808-565-6411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI43-N313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI25187701Medicaid
HIA001428OtherHMSA INPATIENT
HIH001423OtherHMSA OUTPATIENT
HID001422OtherHMSA SNF
HID001422OtherHMSA SNF
HI125023Medicare Oscar/Certification