Provider Demographics
NPI:1801298708
Name:THE QUEEN'S MEDICAL CENTER
Entity type:Organization
Organization Name:THE QUEEN'S MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCDOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-691-5957
Mailing Address - Street 1:1301 PUNCHBOWL ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2499
Mailing Address - Country:US
Mailing Address - Phone:808-691-1000
Mailing Address - Fax:
Practice Address - Street 1:91-2141 FORT WEAVER RD
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-1993
Practice Address - Country:US
Practice Address - Phone:808-691-3000
Practice Address - Fax:808-691-8165
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE QUEEN'S MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-23
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI490417-01Medicaid
HIH4091-8OtherHMSA
HIB4091-1OtherHMSA
HIZ4091-6OtherHMSA
HID4091-7OtherHMSA
HIK4091-1OtherHMSA
HIU4091-7OtherHMSA
HIN4091-4OtherHMSA
HIS4091OtherHMSA
HIN4091OtherHMSA
HI120001Medicare Oscar/Certification