1124026901 NPI number — ISLAND HEALTH CARE LIMITED PARTNERSHIP

Table of content: (NPI 1124026901)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124026901 NPI number — ISLAND HEALTH CARE LIMITED PARTNERSHIP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ISLAND HEALTH CARE LIMITED PARTNERSHIP
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:
ALOHA NURSING REHAB CENTRE
Provider Other Organization Name Type Code:
3
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:
1124026901
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:
45-545 KAMEHAMEHA HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANEOHE
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96744-1943
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-247-2220
Provider Business Mailing Address Fax Number:
808-235-3676

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
45-545 KAMEHAMEHA HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANEOHE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96744-1943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-247-2220
Provider Business Practice Location Address Fax Number:
808-235-3676
Provider Enumeration Date:
07/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HARRIS
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
P
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
808-247-2220

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  28-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: 15940 . This is a "KAISER" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: A7797-2 . This is a "HMSA 65C" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: V261P-2872 . This is a "VA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 031140-01 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".




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