Organization
MAUI MEMORIAL MEDICAL CENTER
Active
Other names
Skilled Nursing Facility
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WESLEY LO (CEO)
(808) 442-5100
Entity
Organization
Contact information
Practice address
221 MAHALANI STREET, WAILUKU, HI 96793
(808) 244-9056
(808) 242-2644
Mailing address
221 MAHALANI STREET, WAILUKU, HI 96793
(808) 244-9056
(808) 242-2644
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
OHCA 69-N
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00005796
—
HI
01
—
G005186
SNF HMSA
HI
Enumeration date
10/18/2006
Last updated
08/22/2020
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