1184612764 NPI number — THE QUEEN'S MEDICAL CENTER

Table of content: (NPI 1184612764)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184612764 NPI number — THE QUEEN'S MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE QUEEN'S 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:
1184612764
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:
ATTN: MANAGED CARE CONTRACTING
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96813-2499
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-691-5949
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
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:
10/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MCDOWELL
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CHIEF FINANCE OFFICER
Authorized Official Telephone Number:
808-691-5957

Provider Taxonomy Codes

  • Taxonomy code: 273R00000X , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 29-H , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 323P00000X , 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: U4091-7 . This is a "HMSA QUEST ASC" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: Z4091-6 . This is a "HMSA QUEST ICF LEVEL R&B" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 490417-01 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".
  • Identifier: H4091-8 . This is a "HMSA QUEST OP HOSPITAL" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: H4091-8 . This is a "HMSA OUTPATIENT" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: U4091-7 . This is a "HMSA ASC" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: B4091-1 . This is a "HMSA OP PHARMACY" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: K4091-1 . This is a "HMSA QUEST SNF & ICF ANC" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: S4091 . This is a "HMSA DENTAL" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: N4091-4 . This is a "HMSA IP HOSPITAL" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 120001 . This is a "HMSA 65C MEDICARE ADVANT" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: D4091-7 . This is a "HMSA QUEST SNF LEVEL R&B" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: H4091-8 . This is a "HMSA DAY TREATMENT" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: N4091-4 . This is a "HMSA QUEST IP HOSPITAL" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: T2469-9 . This is a "HMSA QUEST PUCC" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 02469-5 . This is a "HMSA 65C OP MEDICARE ADV" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 0020 . This is a "TRICARE HOSPITAL" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: N4091 . This is a "HMSA QUEST DAY TREATMENT" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 112974600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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