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General NPI Number Information
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NPI Number | 1629167754
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Entity Type | Organization
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Legal Business Name | MAUI MEMORIAL MEDICAL CENTER
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 221 MAHALANI STREET
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City | WAILUKU
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State | HI
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Zip | 96793
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Country | US
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Telephone | 808-270-4236
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Fax | 808-242-2644
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Provider Business Mailing Address
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Address Line | 221 MAHALANI STREET
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City | WAILUKU
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State | HI
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Zip | 96793
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Country | US
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Telephone | 808-270-4236
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Fax | 808-242-2644
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. WESLEY LO
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Credential |
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Telephone | 808-442-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | OHCA 3-H
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License Number State | HI
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