Healthcare Provider Details

I. General information

NPI: 1659501096
Provider Name (Legal Business Name): LANAI COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2009
Last Update Date: 04/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 SEVENTH ST
LANAI CITY HI
96763
US

IV. Provider business mailing address

PO BOX 630650
LANAI CITY HI
96763-0650
US

V. Phone/Fax

Practice location:
  • Phone: 808-565-8450
  • Fax: 808-565-8474
Mailing address:
  • Phone: 808-565-8450
  • Fax: 808-565-8474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License NumberE00587
License Number StateHI

VIII. Authorized Official

Name: CAROLE STARBIRD
Title or Position: ASSISTANT ADMINISTRATOR
Credential:
Phone: 808-242-2648