Healthcare Provider Details

I. General information

NPI: 1306640412
Provider Name (Legal Business Name): SHALOM HOSPICE OF HAWAII LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

677 ALA MOANA BLVD STE 725
HONOLULU HI
96813-5417
US

IV. Provider business mailing address

677 ALA MOANA BLVD STE 725
HONOLULU HI
96813-5417
US

V. Phone/Fax

Practice location:
  • Phone: 808-556-5900
  • Fax: 808-490-0960
Mailing address:
  • Phone: 808-556-5900
  • Fax: 808-490-0960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL STERN
Title or Position: CEO
Credential:
Phone: 510-499-9977