Provider Demographics
NPI:1366065591
Name:THE QUEEN'S MEDICAL CENTER
Entity type:Organization
Organization Name:THE QUEEN'S MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-691-4600
Mailing Address - Street 1:1301 PUNCHBOWL ST # 204
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2402
Mailing Address - Country:US
Mailing Address - Phone:808-691-4600
Mailing Address - Fax:
Practice Address - Street 1:1401 S BERETANIA ST STE 350
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1871
Practice Address - Country:US
Practice Address - Phone:808-941-2244
Practice Address - Fax:808-955-6605
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE QUEEN'S MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center