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NPI 1285746107

NPI 1285746107 : PAYLESS MARKETS INC : TAMUNING, GU

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General NPI Number Information
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    NPI Number           |    1285746107
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    Entity Type          |    Organization 
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    Legal Business Name  |    PAYLESS MARKETS INC 
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Dates
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    Enumeration Date     |    08/31/2006
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    Last Update Date     |    02/10/2025
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Provider Practice Location Address
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    Address Line         |    275 FARENHOLT AVE STE 208 
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    City                 |    TAMUNING
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    State                |    GU
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    Zip                  |    96913-3217
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    Country              |    US
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    Telephone            |    671-646-6183
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    Fax                  |    671-649-2724
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Provider Business Mailing Address
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    Address Line         |    275 FARENHOLT AVE STE 208 
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    City                 |    TAMUNING
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    State                |    GU
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    Zip                  |    96913-3217
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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    |    GEN MGR
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    Name                 |     MICHAEL  BENITO 
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    Credential           |    RPH
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    Telephone            |    671-477-9266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    333600000X
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    Taxonomy Name        |    Pharmacy
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    3336C0003X
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    Taxonomy Name        |    Community/Retail Pharmacy
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    License Number       |    PCY034
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    License Number State |    GU
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