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General NPI Number Information
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NPI Number | 1326048406
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Entity Type | Organization
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Legal Business Name | HOSPICE OF HILO
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 06/15/2012
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Provider Practice Location Address
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Address Line | 1011 WAIANUENUE AVE
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City | HILO
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State | HI
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Zip | 96720-2019
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Country | US
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Telephone | 808-969-1733
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Fax | 808-969-4863
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Provider Business Mailing Address
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Address Line | 1011 WAIANUENUE AVE
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City | HILO
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State | HI
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Zip | 96720-2019
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Country | US
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Telephone | 808-969-1733
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Fax | 808-961-7397
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. BRENDA HO
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Credential | RN MS
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Telephone | 808-969-1733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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