Healthcare Provider Details

I. General information

NPI: 1154111607
Provider Name (Legal Business Name): KAU HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/08/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 MOHOULI ST STE 200
HILO HI
96720-7210
US

IV. Provider business mailing address

PO BOX 40
PAHALA HI
96777-0040
US

V. Phone/Fax

Practice location:
  • Phone: 808-932-4215
  • Fax: 808-933-9291
Mailing address:
  • Phone: 808-932-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TINA BROWN
Title or Position: REGIONAL REVENUE CYLE DIRECTOR
Credential:
Phone: 360-990-1874