Healthcare Provider Details

I. General information

NPI: 1285858290
Provider Name (Legal Business Name): COMMONWEALTH HEALTHCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 11/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LOWER NAVY HILL ROAD
SAIPAN MP
96950-0409
US

IV. Provider business mailing address

P O BOX 500409
SAIPAN MP
96950-0409
US

V. Phone/Fax

Practice location:
  • Phone: 670-234-8950
  • Fax: 670-236-8756
Mailing address:
  • Phone: 670-234-8950
  • Fax: 670-236-8756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number StateMP
# 3
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number662300
License Number State

VIII. Authorized Official

Name: MRS. ESTHER L MUNA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 670-234-8950