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Organization

HILO MEDICAL CENTER HOME HEALTH EPSDT

Active
Parent organization
HILO MEDICAL CENTER
Organization subpart
Yes

Provider details

NPI number
Legal business name
HILO MEDICAL CENTER
Authorized official
RONALD SCHURRA (CEO)
(808) 974-4729
Entity
Organization

Contact information

Practice address
1190 WAIANUENUE AVE, HILO, HI 96720-2020
(808) 974-7720
(808) 974-4718
Mailing address
1190 WAIANUENUE AVE, HILO, HI 96720-2020
(808) 974-7720
(808) 974-4718

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
OHCA# HHA-2
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
53345701
HI
Enumeration date
09/03/2008
Last updated
09/03/2008
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