MEDICARE: KAU HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174777916
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAU HOSPITAL

Provider Business Mailing Address
First Line	:	15-2660 PAHOA VILLAGE ROAD
Second Line	:	SUITE 306, PMB 8741
City	:	PAHOA
State	:	HI
Zip	:	96778-7802
Country	:	US
Telephone Number	:	808-965-1801
Fax Number	:

Provider Business Practice Location Address
First Line	:	15-2662 PAHOA VILLAGE RD
Second Line	:	SUITE 301, 303-305, 307
City	:	PAHOA
State	:	HI
Zip	:	96778-7730
Country	:	US
Telephone Number	:	808-965-1801
Fax Number	:

Authorized Official
Title or Position	:	RURAL HEALTH CLINIC PRACTICE ADMIN
Name	:	LAURI ELIZABETH REDUS
Credential	:
Telephone Number	:	808-932-3801

Provider Enumeration Date	:	11/06/2008
Last Update Date	:	10/10/2024

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Directions to “KAU HOSPITAL ” Practice Location

Language	Start Address	Practice Location

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