Healthcare Provider Details

I. General information

NPI: 1942277967
Provider Name (Legal Business Name): GURUSAMY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 CHALAN PASAHERU UNIT 2
TAMUNING GU
96913-4132
US

IV. Provider business mailing address

PO BOX 8838
TAMUNING GU
96931-8838
US

V. Phone/Fax

Practice location:
  • Phone: 671-647-5355
  • Fax: 671-649-0404
Mailing address:
  • Phone: 671-647-5355
  • Fax: 671-647-5358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13-200400954-010
License Number StateGU
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. RUTH GURUSAMY
Title or Position: PRESIDENT
Credential: RN, MN
Phone: 671-647-5355