Basic Information
| Provider Information | |||||||||
| NPI: | 1962584060 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HILO MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 73 PUUHONU PL | ||||||||
| Address2: | |||||||||
| City: | HILO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967202060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089342009 | ||||||||
| FaxNumber: | 8089342041 | ||||||||
| Practice Location | |||||||||
| Address1: | 1190 WAIANUENUE AVE | ||||||||
| Address2: | |||||||||
| City: | HILO | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967202020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8089746709 | ||||||||
| FaxNumber: | 8089746723 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2006 | ||||||||
| LastUpdateDate: | 10/30/2007 | ||||||||
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| AuthorizedOfficialLastName: | MURAYAMA | ||||||||
| AuthorizedOfficialFirstName: | BOYD | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL GROUP PRACTICE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8089616525 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 34H | HI | Y | Hospitals | General Acute Care Hospital |
No ID Information.