MEDICARE: KAGMAN COMMUNITY HEALTH CENTER 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	261QF0400X	Federally Qualified Health Center (FQHC)	22150-0001-1	MP

General Provider Information

NPI Number	:	1770002446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAGMAN COMMUNITY HEALTH CENTER INC

Provider Business Mailing Address
First Line	:	PO BOX 355
Second Line	:
City	:	SAIPAN
State	:	MP
Zip	:	96950-6005
Country	:	US
Telephone Number	:	670-234-5242
Fax Number	:	670-234-5245

Provider Business Practice Location Address
First Line	:	6690 COMMERCIAL BUILDING
Second Line	:
City	:	SAIPAN
State	:	MP
Zip	:	96950
Country	:	US
Telephone Number	:	670-256-5242
Fax Number	:	670-256-5249

Authorized Official
Title or Position	:	CHIEF OPERATIONS OFFICER
Name	:	NORMA DELEON GUERRERO BORJA
Credential	:
Telephone Number	:	670-287-5242

Provider Enumeration Date	:	09/14/2017
Last Update Date	:	03/02/2026

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