Healthcare Provider Details

I. General information

NPI: 1881695476
Provider Name (Legal Business Name): QUEEN'S DEVELOPMENT CORPORATION & SUBSIDIARIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 LUSITANA ST
HONOLULU HI
96813-2449
US

IV. Provider business mailing address

1380 LUSITANA ST STREET LEVEL
HONOLULU HI
96813-2449
US

V. Phone/Fax

Practice location:
  • Phone: 808-547-4745
  • Fax: 808-547-4064
Mailing address:
  • Phone: 808-691-4745
  • Fax: 808-691-4064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPHY-470
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY-470
License Number StateHI

VIII. Authorized Official

Name: MR. SCOTT WHITING
Title or Position: PRESIDENT
Credential:
Phone: 808-691-1980