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NPI Code Detail

MEDICARE: ST. FRANCIS MEDICAL CENTER - LEEWARD DIALYSIS

MEDICARE: ST. FRANCIS MEDICAL CENTER - LEEWARD DIALYSIS
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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number : 1528121902
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST. FRANCIS MEDICAL CENTER - LEEWARD DIALYSIS
Provider Business Mailing Address
First Line : PO BOX 29700
Second Line :
City : HONOLULU
State : HI
Zip : 96820-2100
Country : US
Telephone Number : 808-547-6000
Fax Number :
Provider Business Practice Location Address
First Line : 91-2137 FORT WEAVER RD
Second Line :
City : EWA BEACH
State : HI
Zip : 96706-1993
Country : US
Telephone Number : 808-547-6000
Fax Number :
Authorized Official
Title or Position : CEO
Name : SISTER AGNELLE CHING
Credential :
Telephone Number : 808-547-6000
Provider Enumeration Date : 12/18/2006
Last Update Date : 08/22/2020

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