Healthcare Provider Details

I. General information

NPI: 1235515396
Provider Name (Legal Business Name): MOLOKAI GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 03/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 HOMEOLU PLACE
KAUNAKAKAI HI
96748
US

IV. Provider business mailing address

PO BOX 408
KAUNAKAKAI HI
96748-0408
US

V. Phone/Fax

Practice location:
  • Phone: 808-553-5331
  • Fax: 808-553-3133
Mailing address:
  • Phone: 808-553-5331
  • Fax: 808-553-3133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateHI

VIII. Authorized Official

Name: JANICE KALANIHUIA
Title or Position: PRESIDENT
Credential:
Phone: 808-553-5331