Healthcare Provider Details

I. General information

NPI: 1578810792
Provider Name (Legal Business Name): MEDICAL SOLUTION, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2012
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GUALO RAI KIM'S BLDG. SUITE 6B MIDDLE ROAD
SAIPAN MP
96950
US

IV. Provider business mailing address

P.O. BOX 9663
TAMUNING GU
96931-5663
US

V. Phone/Fax

Practice location:
  • Phone: 670-322-2783
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number46060010
License Number StateMP

VIII. Authorized Official

Name: RONALD RAMOS
Title or Position: DIRECTOR
Credential:
Phone: 671-649-3773