1851389365 NPI number — THE QUEENS MEDICAL CENTER - PROGRESSIVE CARE UNIT

Table of content: (NPI 1851389365)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851389365 NPI number — THE QUEENS MEDICAL CENTER - PROGRESSIVE CARE UNIT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE QUEENS MEDICAL CENTER - PROGRESSIVE CARE UNIT
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:
1851389365
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1301 PUNCHBOWL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96813-2402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-538-9011
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 PUNCHBOWL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-538-9011
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
YOSHIOKA
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE VICE PRESIDENT & CAO
Authorized Official Telephone Number:
808-537-7996

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  31-N , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0020 . This is a "TRICARE SNF" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: B2469-1 . This is a "HMSA SNF" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: M4091-7 . This is a "HMSA QUEST PCU/SNF R&B" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 125037 . This is a "HMSA 65C SNF" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: L4091-0 . This is a "HMSA QUEST PCU/SNF ANC" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




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