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GOVERNMENT OF GUAM DEPARTMENT OF ADMINISTRATION NPI 1184796690


NPI Information

NPI: 1184796690
Provider Name: GOVERNMENT OF GUAM DEPARTMENT OF ADMINISTRATION

Doing Business As: SOUTHERN REGION COMMUNITY HEALTH CENTER PHARMACY (SRCHC)

Classification: Pharmacy - 3336C0002X
Entity Type: Organization

Specialization: Clinic Pharmacy

CLIA Number: 65D0670482

Address:
162 AS ABMAN DR
INARAJAN, GU
ZIP 96917
Phone: (671) 828-7547
Get Directions

GOVERNMENT OF GUAM DEPARTMENT OF ADMINISTRATION is a clinic pharmacy pharmacy in Inarajan, GU. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. GOVERNMENT OF GUAM DEPARTMENT OF ADMINISTRATION NPI is 1184796690. The provider is registered as an organization entity type.
The provider Is Doing Business As Southern Region Community Health Center Pharmacy (srchc).

The provider's business location address is:

162 AS ABMAN DR
INARAJAN, GU
ZIP 96917
Phone: (671) 828-7547
Fax: (671) 828-7504

The provider's authorized official is Michelle Deloso .
The authorized official title is Pharmacy Manager and has the following contact phone number (671) 635-7447.

The CLIA number assigned to this NPI record is 65D0670482 - public health laboratories with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/14/2006 and was last updated on 9/28/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail PharmacyNo
23336C0002XPharmacyClinic PharmacyPCY011GUAMYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1636MEDICAIDGUAM
22112062OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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