Healthcare Provider Details

I. General information

NPI: 1801046230
Provider Name (Legal Business Name): GOVERNMENT OF GUAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

238 ARCHBISHOP FLORES ST SUITE 807 DNA BUILDING
HAGATNA GU
96910-5113
US

IV. Provider business mailing address

238 ARCHBISHOP FLORES STREET SUITE 807 DNA BULDING
HAGATNA GUAM
96910
UM

V. Phone/Fax

Practice location:
  • Phone: 671-472-3311
  • Fax: 671-472-3360
Mailing address:
  • Phone: 671-472-3311
  • Fax: 671-472-3360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number001
License Number StateGU

VIII. Authorized Official

Name: MR. DAVID Q. PEREDO
Title or Position: FIRE CHIEF
Credential:
Phone: 671-472-3311