Healthcare Provider Details

I. General information

NPI: 1861434920
Provider Name (Legal Business Name): PACIFIC MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 07/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PMC BUILDING, MIDDLE ROAD GUALO RAI
SAIPAN MP
96950-1908
US

IV. Provider business mailing address

PO BOX 501908
SAIPAN MP
96950-1908
US

V. Phone/Fax

Practice location:
  • Phone: 670-233-8100
  • Fax: 670-233-8102
Mailing address:
  • Phone: 670-233-8100
  • Fax: 670-233-8102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number621111
License Number StateMP

VIII. Authorized Official

Name: MS. SOLEDAD CAMACHO
Title or Position: ADMINISTRATOR
Credential:
Phone: 670-233-8100