Healthcare Provider Details

I. General information

NPI: 1508036161
Provider Name (Legal Business Name): AUGUST HEALTHCARE GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2008
Last Update Date: 09/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FIESTA BLDG BEACH ROAD GARAPAN
SAIPAN MP
96950
US

IV. Provider business mailing address

PO BOX 500173
SAIPAN MP
96950-0173
US

V. Phone/Fax

Practice location:
  • Phone: 670-233-4582
  • Fax: 670-233-4584
Mailing address:
  • Phone: 670-233-4582
  • Fax: 670-233-4584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH C SANTOS
Title or Position: PRESIDENT
Credential: MPH
Phone: 670-483-7667