Healthcare Provider Details
I. General information
NPI: 1427136464
Provider Name (Legal Business Name): MARIANAS HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2006
Last Update Date: 06/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
GHIYEGHI ST. SAN JOSE BLDG STE201 MARIANAS HEALTH LLC
SAIPAN MP
96950-8903
US
IV. Provider business mailing address
PO BOX 10003 PMB 1341
SAIPAN MP
96950-8903
US
V. Phone/Fax
- Phone: 670-233-4646
- Fax: 670-233-4648
- Phone: 670-233-4646
- Fax: 670-233-4648
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
EVELYN
P
DE BELEN
Title or Position: BILLING MANAGER
Credential:
Phone: 670-233-4646