Organization
THE QUEENS COMMUNITY BASED PROGRAMS
Active
Organization
THE QUEENS COMMUNITY BASED PROGRAMS
Active
Parent organization
THE QUEENS MEDICAL CENTER
Other names
The Queens Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE QUEENS MEDICAL CENTER
Authorized official
MR. RIX MAURER III (VICE PRESIDENT FINANCE)
(808) 547-4329
Entity
Organization
Contact information
Practice address
838 SOUTH BERETANIA STREET, #308, HONOLULU, HI 96813-4625
(808) 547-4628
(808) 547-4625
Mailing address
1301 PUNCHBOWL STREET, HONOLULU, HI 96813-2499
(808) 547-4628
(808) 547-4625
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
HCBS0509
HI
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50871501
—
HI
05
—
50871502
—
HI
05
—
50871503
—
HI
05
—
52017301
—
HI
Enumeration date
12/13/2006
Last updated
09/25/2012
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