MEDICARE: MARIANAS HEALTH SERVICES, INC

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	261QP2000X	Physical Therapy Clinic/Center	10723-0004	MP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154537298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARIANAS HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 10003
Second Line	:	PMB 1341
City	:	SAIPAN
State	:	MP
Zip	:	96950-8903
Country	:	US
Telephone Number	:	670-233-4646
Fax Number	:	670-233-4648

Provider Business Practice Location Address
First Line	:	GHIYEGHI ST. SAN JOSE BLDG STE102
Second Line	:	MARIANAS HEALTH LLC
City	:	SAIPAN
State	:	MP
Zip	:	96950-8903
Country	:	US
Telephone Number	:	670-233-4646
Fax Number	:	670-233-4648

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MRS. EVELYN P. DE BELEN
Credential	:
Telephone Number	:	670-233-4646

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	06/12/2015

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Practice Location Address:

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Practice Phone: 670-233-4646
Practice Fax: 670-233-4648

Directions to “MARIANAS HEALTH SERVICES, INC ” Practice Location

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