Healthcare Provider Details

I. General information

NPI: 1962583328
Provider Name (Legal Business Name): LANAI COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 SEVENTH STREET
LANAI HI
96763
US

IV. Provider business mailing address

628 SEVENTH STREET
LANA'I HI
96763
US

V. Phone/Fax

Practice location:
  • Phone: 808-565-6411
  • Fax:
Mailing address:
  • Phone: 808-545-6411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number28-8
License Number StateHI

VIII. Authorized Official

Name: MR. JOHN SCHAUMBURG
Title or Position: ADMINISTRAITOR
Credential:
Phone: 808-565-6411