Healthcare Provider Details

I. General information

NPI: 1164626479
Provider Name (Legal Business Name): QUEEN'S DEVELOPMENT CORPORATION & SUBSIDIARIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

377 KEAHOLE ST
HONOLULU HI
96825-3405
US

IV. Provider business mailing address

1099 ALAKEA ST SUITE 1100
HONOLULU HI
96813-4511
US

V. Phone/Fax

Practice location:
  • Phone: 808-396-6675
  • Fax: 808-395-2104
Mailing address:
  • Phone: 808-535-8737
  • Fax: 808-535-8710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. LEILA SHAR
Title or Position: CFO
Credential:
Phone: 808-535-8737