Provider Demographics
NPI:1831384114
Name:ST. JUDE HOSPICE INCORPORATED
Entity type:Organization
Organization Name:ST. JUDE HOSPICE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELEUTERIO
Authorized Official - Middle Name:CALDERON
Authorized Official - Last Name:ARNOBIT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:808-306-3676
Mailing Address - Street 1:94-910 MOLOALO ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-6302
Mailing Address - Country:US
Mailing Address - Phone:808-306-3676
Mailing Address - Fax:808-678-3604
Practice Address - Street 1:94-910 MOLOALO ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-6302
Practice Address - Country:US
Practice Address - Phone:808-306-3676
Practice Address - Fax:808-678-3604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIW44509341-01251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based