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520 W Santa Monica Ave Dededo GU 96929-5286 | |
(671) 635-7492 | |
(671) 635-7493 |
Full Name | |
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Speciality | Clinic/Center |
Location | 520 W Santa Monica Ave, Dededo, Guam |
Authorized Official Name and Position | Mary Jane H Capuz (ACCOUNTANT II) |
Authorized Official Contact | 6716357545 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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520 W Santa Monica Ave Dededo GU 96929-5286 Ph: (671) 735-7101 | 520 W Santa Monica Ave Dededo GU 96929-5286 Ph: (671) 635-7492 |
NPI Number | 1972577104 |
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Provider Enumeration Date | 02/14/2006 |
Last Update Date | 06/14/2022 |
Medicare PECOS PAC ID | 6103920525 |
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Medicare Enrollment ID | O20070323000566 |
Identifier | Type | State | Issuer |
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1972577104 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Guam) | Primary |
Blue Ocean Medical Group Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 655 Harmon Loop Rd Ste 108, Dededo, GU 96929 Phone: 671-633-4447 | |
Blue Continent Healthcare Guam Medical City Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 133 Route 3, Dededo, GU 96929 Phone: 671-645-5500 | |
International Health Providers, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 655 Harmon Loop Rd, Suite 108, Dededo, GU 96929 Phone: 671-929-6214 | |