Basic Information
| Provider Information | |||||||||
| NPI: | 1225113442 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WILCOX MEMORIAL HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3-3420 KUHIO HWY | ||||||||
| Address2: | |||||||||
| City: | LIHUE | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967661099 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082451100 | ||||||||
| FaxNumber: | 8082451223 | ||||||||
| Practice Location | |||||||||
| Address1: | 3-3420 KUHIO HWY | ||||||||
| Address2: | |||||||||
| City: | LIHUE | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967661099 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082451100 | ||||||||
| FaxNumber: | 8082451223 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | CLARK | ||||||||
| AuthorizedOfficialFirstName: | KATHY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT AND CHIEF EXEC. OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 8082451122 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | RN, BSN, MBA | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 275N00000X | HI | N | Hospital Units | Medicare Defined Swing Bed Unit | 282NR1301X | 23-H | HI | Y | Hospitals | General Acute Care Hospital | Rural |
No ID Information.