Provider Demographics
NPI:1073001293
Name:AGGABAO, JUNE L (RPH)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:L
Last Name:AGGABAO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 NORTH MARINE CORPS DRIVE
Mailing Address - Street 2:
Mailing Address - City:UPPER TUMON
Mailing Address - State:GU
Mailing Address - Zip Code:96913
Mailing Address - Country:US
Mailing Address - Phone:671-646-6515
Mailing Address - Fax:671-646-6516
Practice Address - Street 1:1244 NORTH MARINE CORPS DRIVE
Practice Address - Street 2:
Practice Address - City:UPPER TUMON
Practice Address - State:GU
Practice Address - Zip Code:96913
Practice Address - Country:US
Practice Address - Phone:671-646-6515
Practice Address - Fax:671-646-6516
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUPH035183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist