Itc Pharmacy Ii | |
416 Chalan San Antonio Tamuning GU 96913-3601 | |
(671) 649-1977 | |
(671) 646-5338 |
Full Name | Itc Pharmacy Ii |
---|---|
Speciality | Clinic/center |
Location | 416 Chalan San Antonio, Tamuning, Guam |
Authorized Official Name and Position | Julius Santos Fernando (PHARMACIST) |
Authorized Official Contact | 6716491977 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Itc Pharmacy Ii Po Box 11468 Tamuning GU 96931-1468 Ph: (671) 649-1977 | Itc Pharmacy Ii 416 Chalan San Antonio Tamuning GU 96913-3601 Ph: (671) 649-1977 |
NPI Number | 1265421630 |
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Provider Enumeration Date | 10/19/2005 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265421630 | NPI | - | NPPES |
631 | Medicaid | GU |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | PCY015 (Guam) | Primary |
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