Provider Demographics
NPI:1053344697
Name:ST. FRANCIS COMMUNITY HEALTH SERVICES
Entity type:Organization
Organization Name:ST. FRANCIS COMMUNITY HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:CORREA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:808-547-8004
Mailing Address - Street 1:PO BOX 29700
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96820-2100
Mailing Address - Country:US
Mailing Address - Phone:808-547-8050
Mailing Address - Fax:808-547-8058
Practice Address - Street 1:2228 LILIHA ST
Practice Address - Street 2:SUITE 505
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1650
Practice Address - Country:US
Practice Address - Phone:808-534-0777
Practice Address - Fax:808-676-1300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIHHA-4251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1072OtherALOHA CARE QUEST
HI08553501Medicaid
HIJ210300OtherHMSA 65 C PLUS
HI08553501Medicaid