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General NPI Number Information
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NPI Number | 1003382854
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Entity Type | Organization
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Legal Business Name | COMMONWEALTH HEALTHCARE CORPORATION
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Dates
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Enumeration Date | 10/19/2018
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Last Update Date | 10/19/2018
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Provider Practice Location Address
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Address Line | SAN JOSE VILLAGE CORNER OF CANAL STREET & BROADWAY
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City | TINIAN
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State | MP
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Zip | 96952
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Country | US
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Telephone | 670-433-9233
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 446
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City | TINIAN
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State | MP
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Zip | 96952-0446
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ESTHER L MUNA
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Credential |
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Telephone | 670-234-8950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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