MEDICARE: GUAM MEDICAL EQUIPMENT AND SUPPLIES, LLC

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	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1194820803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUAM MEDICAL EQUIPMENT AND SUPPLIES, LLC

Provider Business Mailing Address
First Line	:	353 CHALAN SAN ANTONIO STE 102-B
Second Line	:
City	:	TAMUNING
State	:	GU
Zip	:	96913-3300
Country	:	US
Telephone Number	:	671-649-4633
Fax Number	:	671-649-4636

Provider Business Practice Location Address
First Line	:	353 CHALAN SAN ANTONIO STE 102-B
Second Line	:
City	:	TAMUNING
State	:	GU
Zip	:	96913-3300
Country	:	US
Telephone Number	:	671-649-4633
Fax Number	:	671-649-4636

Authorized Official
Title or Position	:	MANAGING EMPLOYEE
Name	:	NIDA A LLAMADO
Credential	:
Telephone Number	:	671-649-4633

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	08/22/2020

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