Healthcare Provider Details
I. General information
NPI: 1972565240
Provider Name (Legal Business Name): TAKECARE INSURANCE COMPANY INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/03/2006
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
548 S MARINE CORPS. DR
TAMUNING GU
96913
US
IV. Provider business mailing address
PO BOX 6578
TAMUNING GU
96931-6578
US
V. Phone/Fax
- Phone: 671-646-6956
- Fax: 671-647-3556
- Phone: 671-646-5825
- Fax: 671-647-3556
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | GU |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083X0100X |
| Taxonomy | Occupational Medicine Physician |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 302R00000X |
| Taxonomy | Health Maintenance Organization |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
LUCIO ALBERTO
VILLAMAYOR
ALMIRA
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 671-646-6956