Healthcare Provider Details

I. General information

NPI: 1619499423
Provider Name (Legal Business Name): SAIPAN VISITING NURSES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2017
Last Update Date: 07/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 101 MANGO CITY BLDG MIDDLE RD. GARAPAN, SAIPAN
SAIPAN MP
96950
US

IV. Provider business mailing address

PO BOX 505232
SAIPAN MP
96950-4316
US

V. Phone/Fax

Practice location:
  • Phone: 670-233-0240
  • Fax: 670-233-0241
Mailing address:
  • Phone: 16702330240
  • Fax: 670-233-0241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number21207-0005
License Number StateMP

VIII. Authorized Official

Name: JUMICO ROMERO CHUA
Title or Position: OPERATION MANAGER
Credential:
Phone: 670-233-0240