Healthcare Provider Details
I. General information
NPI: 1841497831
Provider Name (Legal Business Name): WILCOX MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3-3420 KUHIO HWY
LIHUE HI
96766-1042
US
IV. Provider business mailing address
1946 YOUNG ST SUITE 360
HONOLULU HI
96826-2150
US
V. Phone/Fax
- Phone: 808-245-1100
- Fax:
- Phone: 808-973-7320
- Fax: 808-973-7325
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336I0012X |
| Taxonomy | Institutional Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DAVID
OKABE
Title or Position: CFO, SR. VICE PRESIDENT
Credential:
Phone: 808-535-7202