Healthcare Provider Details

I. General information

NPI: 1982276127
Provider Name (Legal Business Name): KAU HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 KAMANI STREET
PAHALA HI
96777
US

IV. Provider business mailing address

PO BOX 40
PAHALA HI
96777-0040
US

V. Phone/Fax

Practice location:
  • Phone: 808-932-4200
  • Fax: 808-928-8980
Mailing address:
  • Phone: 808-932-4200
  • Fax: 808-928-8980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: JONI MU WALTJEN
Title or Position: REGIONAL CFO
Credential:
Phone: 808-932-3110