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General NPI Number Information
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NPI Number | 1619217742
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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 | 02/27/2013
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Last Update Date | 02/16/2015
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Provider Practice Location Address
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Address Line | 1 LEMMAI WAY KAGMAN II BUILDINGS 1 & 2
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City | SAIPAN
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State | MP
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Zip | 96950-0409
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Country | US
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Telephone | 670-256-5242
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Fax | 670-256-5244
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Provider Business Mailing Address
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Address Line | PO BOX 500409 LEMMAI WAY KAGMAN II
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City | SAIPAN
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State | MP
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Zip | 96950-0409
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Country | US
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Telephone | 670-256-5242
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Fax | 670-256-5244
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. VINCENT T CASTRO
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Credential |
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Telephone | 670-256-5242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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