MEDICARE: JUNE L AGGABAO RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PH035	GU

General Provider Information

NPI Number	:	1073001293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUNE L AGGABAO RPH

Provider Business Mailing Address
First Line	:	1244 NORTH MARINE CORPS DRIVE
Second Line	:
City	:	UPPER TUMON
State	:	GU
Zip	:	96913
Country	:	US
Telephone Number	:	671-646-6515
Fax Number	:	671-646-6516

Provider Business Practice Location Address
First Line	:	1244 NORTH MARINE CORPS DRIVE
Second Line	:
City	:	UPPER TUMON
State	:	GU
Zip	:	96913
Country	:	US
Telephone Number	:	671-646-6515
Fax Number	:	671-646-6516

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2018
Last Update Date	:	04/24/2018

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