Provider Demographics
NPI:1740524560
Name:NORTH HAWAII COMMUNITY HOSPITAL, INC
Entity type:Organization
Organization Name:NORTH HAWAII COMMUNITY HOSPITAL, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:D
Authorized Official - Last Name:PARET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-881-4406
Mailing Address - Street 1:67-1125 MAMALAHOA HWY
Mailing Address - Street 2:PO BOX 2799
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-8496
Mailing Address - Country:US
Mailing Address - Phone:808-881-4406
Mailing Address - Fax:808-881-4404
Practice Address - Street 1:67-1125 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743
Practice Address - Country:US
Practice Address - Phone:808-881-4406
Practice Address - Fax:808-881-4404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI39-H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI7835201Medicaid
HI7835201Medicaid