Healthcare Provider Details

I. General information

NPI: 1245926286
Provider Name (Legal Business Name): DEPARTMENT OF SEARCH AND RESCUE (SAR)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 04/13/2023
Certification Date: 03/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 TAFUNA ROAD EMS TAFUNA OFFICE ROAD
PAGO PAGO AS
96799
US

IV. Provider business mailing address

PO BOX 5050
PAGO PAGO AS
96799
US

V. Phone/Fax

Practice location:
  • Phone: 684-699-7002
  • Fax:
Mailing address:
  • Phone: 684-699-4462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. FAAMASINO UPUESE GALOIA
Title or Position: DIRECTOR
Credential:
Phone: 684-699-4462