Healthcare Provider Details

I. General information

NPI: 1164260857
Provider Name (Legal Business Name): CARDINAL HEALTHCARE MANAGEMENT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2024
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3290 BEACH ROAD PLAZA SUITE 04
SAIPAN MP
96950
US

IV. Provider business mailing address

PO BOX 7492
SAIPAN MP
96950-7492
US

V. Phone/Fax

Practice location:
  • Phone: 670-285-8775
  • Fax:
Mailing address:
  • Phone: 670-285-8775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ELAINE Q TERLAJE
Title or Position: GENERAL MANAGER/ADMINISTRATOR
Credential:
Phone: 670-285-8775