Healthcare Provider Details

I. General information

NPI: 1447683966
Provider Name (Legal Business Name): GUAM MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2013
Last Update Date: 09/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 GOV CARLOS G CAMACHO RD
TAMUNING GU
96913-3128
US

IV. Provider business mailing address

850 GOV CARLOS G CAMACHO RD
TAMUNING GU
96913-3128
US

V. Phone/Fax

Practice location:
  • Phone: 671-647-2556
  • Fax: 671-649-0145
Mailing address:
  • Phone: 671-647-2556
  • Fax: 671-649-0145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateGU
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateGU

VIII. Authorized Official

Name: MR. JOSEPH P VERGA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: M.S., FACHE
Phone: 671-647-2418