Healthcare Provider Details

I. General information

NPI: 1154310878
Provider Name (Legal Business Name): MEGGS CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2005
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

646 S MARINE DR
TAMUNING GU
96913-3503
US

IV. Provider business mailing address

646 S MARINE DR
TAMUNING GU
96913-3503
US

V. Phone/Fax

Practice location:
  • Phone: 671-646-4827
  • Fax: 671-649-0051
Mailing address:
  • Phone: 671-646-4827
  • Fax: 671-649-0051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPCY006
License Number StateGU

VIII. Authorized Official

Name: MILDRED M GABRIEL
Title or Position: PRESIDENT
Credential: RPH
Phone: 671-649-3784