Healthcare Provider Details

I. General information

NPI: 1609637503
Provider Name (Legal Business Name): MA. HASMINE JOY ZAPANTA MARIANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2024
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 FARENHOLT AVE STE B
TAMUNING GU
96913-3217
US

IV. Provider business mailing address

285 FARENHOLT AVE UNIT 303 PMB 1032
TAMUNING GU
96913
US

V. Phone/Fax

Practice location:
  • Phone: 671-646-6183
  • Fax: 671-649-2724
Mailing address:
  • Phone: 671-483-8810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH0574
License Number StateGU

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: