Healthcare Provider Details
I. General information
NPI: 1588987119
Provider Name (Legal Business Name): MARIANAS HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/10/2010
Last Update Date: 03/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
SAIPAN PLAZA BUILDING STE#7 CHALAN PALE ARNOLD GARAPAN
SAIPAN MP
96950-8903
US
IV. Provider business mailing address
POB 10003 PMB 1341
SAIPAN MP
96950-8903
US
V. Phone/Fax
- Phone: 670-233-4646
- Fax: 670-233-4648
- Phone: 670-233-4646
- Fax: 670-233-4648
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 10723-009 10723-008 |
| License Number State | MP |
VIII. Authorized Official
Name: MR.
GEORGE
J
CRUZ
Title or Position: PRESIDENT
Credential:
Phone: 670-233-4646