Healthcare Provider Details

I. General information

NPI: 1043535735
Provider Name (Legal Business Name): MARIANAS HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2010
Last Update Date: 04/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PMB 1341 SAIPAN PLAZA BUILDING STE#7 CHALAN PALE ARNOLD GARAPAN
SAIPAN MP
96950-8903
US

IV. Provider business mailing address

PO BOX 10003 SAIPAN PLAZA BUILDING STE#7 CHALAN PALE ARNOLD GARAPAN
SAIPAN MP
96950-8903
US

V. Phone/Fax

Practice location:
  • Phone: 670-233-4646
  • Fax: 670-233-4648
Mailing address:
  • Phone: 670-233-4646
  • Fax: 670-233-4648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number10723-0010
License Number StateMP

VIII. Authorized Official

Name: MR. GEORGE J. CRUZ
Title or Position: PRESIDENT
Credential:
Phone: 670-233-4646