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General NPI Number Information
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NPI Number | 1740407840
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Entity Type | Organization
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Legal Business Name | KAISER FOUNDATION HOSPITALS
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 02/28/2017
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Provider Practice Location Address
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Address Line | 1292 WAIANUENUE AVE
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City | HILO
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State | HI
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Zip | 96720-1228
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Country | US
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Telephone | 808-934-4090
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Fax | 808-934-4089
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Provider Business Mailing Address
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Address Line | 1292 WAIANUENUE AVE
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City | HILO
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State | HI
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Zip | 96720-1228
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Country | US
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Telephone | 808-934-4090
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Fax | 808-934-4089
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | ROBERT SANDSTROM
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Credential | PHARMD
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Telephone | 808-934-4090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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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 | 3336M0003X
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Taxonomy Name | Managed Care Organization Pharmacy
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License Number | PHY563
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License Number State | HI
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