Provider Demographics
NPI:1003382854
Name:COMMONWEALTH HEALTHCARE CORPORATION
Entity Type:Organization
Organization Name:COMMONWEALTH HEALTHCARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:MUNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:670-234-8950
Mailing Address - Street 1:PO BOX 446
Mailing Address - Street 2:
Mailing Address - City:TINIAN
Mailing Address - State:MP
Mailing Address - Zip Code:96952-0446
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:SAN JOSE VILLAGE
Practice Address - Street 2:CORNER OF CANAL STREET & BROADWAY
Practice Address - City:TINIAN
Practice Address - State:MP
Practice Address - Zip Code:96952
Practice Address - Country:US
Practice Address - Phone:670-433-9233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMONWEALTH HEALTHCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health