Provider Demographics
NPI:1780756205
Name:HAWAII MEDICAL CENTER EAST
Entity type:Organization
Organization Name:HAWAII MEDICAL CENTER EAST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSTYLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-547-6415
Mailing Address - Street 1:PO BOX 29840
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96820-2240
Mailing Address - Country:US
Mailing Address - Phone:808-547-6011
Mailing Address - Fax:
Practice Address - Street 1:2230 LILIHA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1646
Practice Address - Country:US
Practice Address - Phone:808-547-6011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00C0263958OtherHMSA - SNF
HI55826201Medicaid
HI00E0263953OtherHMSA QUEST - SNF WL
HI00E0263953OtherHMSA QUEST - SNF WL
125025Medicare Oscar/Certification