Healthcare Provider Details

I. General information

NPI: 1891051850
Provider Name (Legal Business Name): HOSPICE OF HILO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 KAPIOLANI ST
HILO HI
96720
US

IV. Provider business mailing address

1011 WAIANUENUE AVE
HILO HI
96720-2019
US

V. Phone/Fax

Practice location:
  • Phone: 808-969-1733
  • Fax: 808-961-7397
Mailing address:
  • Phone: 808-969-1733
  • Fax: 808-961-7397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRENDA SUE HO
Title or Position: CEO
Credential: MS RN
Phone: 808-969-1733