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

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 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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