Healthcare Provider Details

I. General information

NPI: 1902059579
Provider Name (Legal Business Name): CASTLE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

642 ULUKAHIKI STREET
KAILUA HI
96734-4454
US

IV. Provider business mailing address

640 ULUKAHIKI ST
KAILUA HI
96734-4454
US

V. Phone/Fax

Practice location:
  • Phone: 808-363-5176
  • Fax:
Mailing address:
  • Phone: 808-263-5500
  • Fax: 808-266-3617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateHI

VIII. Authorized Official

Name: MR. DALE NORTHROP
Title or Position: CFO
Credential:
Phone: 808-263-5142