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General NPI Number Information
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NPI Number | 1548140007
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Entity Type | Organization
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Legal Business Name | GOVERNMENT OF GUAM DEPARTMENT OF ADMINISTRATION
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Dates
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Enumeration Date | 09/05/2025
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 520 W SANTA MONICA AVE
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City | DEDEDO
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State | GU
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Zip | 96929-5286
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Country | US
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Telephone | 671-788-4098
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Fax |
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Provider Business Mailing Address
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Address Line | 123 CHALAN KARETA
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City | MANGILAO
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State | GU
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Zip | 96913-6304
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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 | PHARMACY MANAGER
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Name | JESSICA YANIT
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Credential |
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Telephone | 671-735-7139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional 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 | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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