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General NPI Number Information
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NPI Number | 1386783629
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Entity Type | Organization
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Legal Business Name | PRIME CARE INC
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 851 GOVERNOR CARLOS CAMACHO RD
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City | TAMUNING
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State | GU
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Zip | 96913
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Country | US
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Telephone | 671-649-9400
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Fax | 671-649-1455
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Provider Business Mailing Address
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Address Line | PO BOX 11864
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City | TAMUNING
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State | GU
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Zip | 96913
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Country | US
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Telephone | 671-649-9400
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Fax | 671-649-1455
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Authorized Official
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Title or Position | BUSINESS ADMIN
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Name | MS. MARY CHARGUALAF
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Credential |
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Telephone | 671-632-6001
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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 | PCY048
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License Number State | GU
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