Healthcare Provider Details

I. General information

NPI: 1922321165
Provider Name (Legal Business Name): GUAM FIRE DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 03/02/2010
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 FLEXIBERTO FLORES ST. SUITE 807 DNA BUILDING
HAGATNA GU
96910-5205
US

V. Phone/Fax

Practice location:
  • Phone: 671-472-3311
  • Fax: 671-472-6630
Mailing address:
  • Phone: 671-472-9911
  • Fax: 671-472-6630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberPL17-78
License Number StateGU

VIII. Authorized Official

Name: MR. DAVID QUIFUNAS PEREDO
Title or Position: FIRE CHIEF
Credential:
Phone: 671-472-3321