Healthcare Provider Details

I. General information

NPI: 1194237578
Provider Name (Legal Business Name): MARVIR CALIGUIA RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2017
Last Update Date: 10/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 ROUTE 4 STE 104
SINAJANA GU
96910-3368
US

IV. Provider business mailing address

160 NIJOK AVE
MANGILAO GU
96913-5728
US

V. Phone/Fax

Practice location:
  • Phone: 671-472-4780
  • Fax: 671-472-4782
Mailing address:
  • Phone: 671-788-1226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH-088
License Number StateGU

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: