Healthcare Provider Details

I. General information

NPI: 1053497040
Provider Name (Legal Business Name): HONOKAA HOSPITAL & SKILLED NURSING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45-547 PLUMERIA ST
HONOKAA HI
96727-6902
US

IV. Provider business mailing address

45-547 PLUMERIA ST
HONOKAA HI
96727-6902
US

V. Phone/Fax

Practice location:
  • Phone: 808-775-7211
  • Fax: 808-775-9977
Mailing address:
  • Phone: 808-775-7211
  • Fax: 808-775-9977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberOHCA# 41-N
License Number StateHI

VIII. Authorized Official

Name: KERRY PITCHER
Title or Position: HOSPITAL ADMINISTRATOR
Credential:
Phone: 808-932-3588