=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164506317
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HONOKAA HOSPITAL & SKILLED NURSING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2006
-----------------------------------------------------
Last Update Date | 07/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 45-547 PLUMERIA ST
-----------------------------------------------------
City | HONOKAA
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96727-6902
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-775-7211
-----------------------------------------------------
Fax | 808-775-9977
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 45-547 PLUMERIA ST
-----------------------------------------------------
City | HONOKAA
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96727-6902
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-775-7211
-----------------------------------------------------
Fax | 808-775-9977
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | HOSPITAL ADMINISTRATOR
-----------------------------------------------------
Name | KERRY PITCHER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 808-932-3588
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282NC0060X
-----------------------------------------------------
Taxonomy Name | Critical Access Hospital
-----------------------------------------------------
License Number | OHCA# 5-H
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------