MEDICARE: QUEEN'S DEVELOPMENT CORPORATION & SUBSIDIARIES

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	333600000X	Pharmacy	PHY-470	HI
2	332B00000X	Durable Medical Equipment & Medical Supplies	PHY-470	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1201451	OTHER	HI	NCPDP NUMBER
2	1201451	OTHER	HI	NABP NUMBER
3	085392-01	OTHER	HI	HMSA - BLUE CROSS/BLUE SH
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881695476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUEEN'S DEVELOPMENT CORPORATION & SUBSIDIARIES

Provider Business Mailing Address
First Line	:	1380 LUSITANA ST
Second Line	:	STREET LEVEL
City	:	HONOLULU
State	:	HI
Zip	:	96813-2449
Country	:	US
Telephone Number	:	808-691-4745
Fax Number	:	808-691-4064

Provider Business Practice Location Address
First Line	:	1380 LUSITANA ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-2449
Country	:	US
Telephone Number	:	808-547-4745
Fax Number	:	808-547-4064

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. SCOTT WHITING
Credential	:
Telephone Number	:	808-691-1980

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	12/31/2024

Similar Medicare Providers

1023016383 — DR. DENNY L BALES M.D.
Practice Location Address:

1380 LUSITANA ST , SUITE 1002
HONOLULU, HI
96813-2449

Practice Phone: 808-521-7402
Practice Fax: 808-537-2094

1609861822 — DR. EDWARD N SHEN MD
Practice Location Address:

1380 LUSITANA ST , STE 701
HONOLULU, HI
96813-2449

Practice Phone: 808-587-8200
Practice Fax: 808-531-8201

1972598605 — DR. EUGENE G C WONG MD
Practice Location Address:

1380 LUSITANA ST , SUITE 814
HONOLULU, HI
96813-2449

Practice Phone: 808-521-3802
Practice Fax: 808-521-1738

1982691341 — RICHARD LANCE DEJOURNETT M.D.
Practice Location Address:

1380 LUSITANA ST , SECOND FLOOR
HONOLULU, HI
96813-2449

Practice Phone: 808-599-4471
Practice Fax: 808-523-3849

1497738686 — DR. WILLIAM GEORGE OBANA M.D.
Practice Location Address:

1380 LUSITANA ST , SUITE #410
HONOLULU, HI
96813-2449

Practice Phone: 808-523-9993
Practice Fax: 808-523-9992

1700869427 — DR. DOUGLAS WAYNE JOHNSON M.D.
Practice Location Address:

1380 LUSITANA ST , SUITE 401
HONOLULU, HI
96813-2449

Practice Phone: 808-531-7541
Practice Fax: 808-531-7542

Directions to “QUEEN'S DEVELOPMENT CORPORATION & SUBSIDIARIES ” Practice Location

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