Provider Demographics
NPI:1043535735
Name:MARIANAS HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:MARIANAS HEALTH SERVICES, INC
Other - Org Name:MHS HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:670-233-4646
Mailing Address - Street 1:PO BOX 10003
Mailing Address - Street 2:SAIPAN PLAZA BUILDING STE#7 CHALAN PALE ARNOLD GARAPAN
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-8903
Mailing Address - Country:US
Mailing Address - Phone:670-233-4646
Mailing Address - Fax:670-233-4648
Practice Address - Street 1:PMB 1341
Practice Address - Street 2:SAIPAN PLAZA BUILDING STE#7 CHALAN PALE ARNOLD GARAPAN
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950-8903
Practice Address - Country:US
Practice Address - Phone:670-233-4646
Practice Address - Fax:670-233-4648
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARIANAS HEALTH SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MP10723-0010251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MP3R-015Medicaid
667001Medicare Oscar/Certification