Healthcare Provider Details

I. General information

NPI: 1467510743
Provider Name (Legal Business Name): KAUAI VETERANS MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4643 WAIMEA CANYON DRIVE
WAIMEA HI
96796-0337
US

IV. Provider business mailing address

PO BOX 337
WAIMEA HI
96796-0337
US

V. Phone/Fax

Practice location:
  • Phone: 808-338-9431
  • Fax: 808-338-9420
Mailing address:
  • Phone: 808-338-9431
  • Fax: 808-338-9420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number21-H
License Number StateHI

VIII. Authorized Official

Name: CHRISTINE MARIE ASATO
Title or Position: REGIONAL CFO
Credential:
Phone: 808-338-9407