Healthcare Provider Details

I. General information

NPI: 1366486979
Provider Name (Legal Business Name): MOLOKAI GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 03/10/2008
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:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number34-N/18-H
License Number StateHI

VIII. Authorized Official

Name: JANICE KALANIHUIA
Title or Position: PRESIDENT
Credential:
Phone: 808-553-3123