1235262114 NPI number — CASTLE MEDICAL CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235262114 NPI number — CASTLE MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CASTLE MEDICAL CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235262114
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
640 ULUKAHIKI ST
Provider Second Line Business Mailing Address:
INPATIENT PHARMACY
Provider Business Mailing Address City Name:
KAILUA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96734-4454
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-263-5192
Provider Business Mailing Address Fax Number:
808-263-5408

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
640 ULUKAHIKI ST
Provider Second Line Business Practice Location Address:
INPATIENT PHARMACY
Provider Business Practice Location Address City Name:
KAILUA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96734
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-263-5192
Provider Business Practice Location Address Fax Number:
808-263-5408
Provider Enumeration Date:
03/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DUNCAN
Authorized Official First Name:
DOUGLAS
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACY DIRECTOR
Authorized Official Telephone Number:
808-263-5192

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  PHY-197 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0003X , with the licence number: PHY197 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: B0501-3 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1201742 . This is a "NCPDP (NATIONAL COUNCIL FOR PRESCRIPTION DRUG PROGRAMS)" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




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