Provider Demographics
NPI:1306640412
Name:SHALOM HOSPICE OF HAWAII LLC
Entity type:Organization
Organization Name:SHALOM HOSPICE OF HAWAII LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-499-9977
Mailing Address - Street 1:677 ALA MOANA BLVD STE 725
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5417
Mailing Address - Country:US
Mailing Address - Phone:808-556-5900
Mailing Address - Fax:808-490-0960
Practice Address - Street 1:677 ALA MOANA BLVD STE 725
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5417
Practice Address - Country:US
Practice Address - Phone:808-556-5900
Practice Address - Fax:808-490-0960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based