Healthcare Provider Details
I. General information
NPI: 1659409266
Provider Name (Legal Business Name): CASTLE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
46-001 KAMEHAMEHA HWY STE 212
KANEOHE HI
96744-3732
US
IV. Provider business mailing address
640 ULUKAHIKI ST
KAILUA HI
96734-4454
US
V. Phone/Fax
- Phone: 808-247-2828
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DALE
NORTHROP
Title or Position: VICE PRESIDENT OF FINANCE
Credential:
Phone: 808-263-5142