Healthcare Provider Details

I. General information

NPI: 1225133457
Provider Name (Legal Business Name): HAWAII MEDICAL CENTER WEST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 10/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-2141 FORT WEAVER RD
EWA BEACH HI
96706-1993
US

IV. Provider business mailing address

PO BOX 29759
HONOLULU HI
96820-2159
US

V. Phone/Fax

Practice location:
  • Phone: 808-678-7100
  • Fax: 808-678-7486
Mailing address:
  • Phone: 808-678-7100
  • Fax: 808-678-7486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MARIA KOSTYLO
Title or Position: CEO
Credential:
Phone: 808-547-6415