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General NPI Number Information
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NPI Number | 1801966783
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Entity Type | Organization
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Legal Business Name | KAU HOSPITAL
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 02/07/2011
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Provider Practice Location Address
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Address Line | 1 KAMANI STREET
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City | PAHALA
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State | HI
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Zip | 96777
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Country | US
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Telephone | 808-928-2050
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Fax | 808-928-8980
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Provider Business Mailing Address
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Address Line | PO BOX 40
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City | PAHALA
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State | HI
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Zip | 96777-0040
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Country | US
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Telephone | 808-928-2050
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Fax | 808-928-8980
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MERILYN HARRIS
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Credential |
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Telephone | 808-928-2050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 125028
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License Number State | HI
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