Provider Demographics
NPI:1184660045
Name:HEALTH SERVICES & MANAGEMENT INC.
Entity Type:Organization
Organization Name:HEALTH SERVICES & MANAGEMENT INC.
Other - Org Name:PMC ISLA HEALTH SYSTEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARIETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDESMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:671-649-4501
Mailing Address - Street 1:177A CHALAN PASAHERU
Mailing Address - Street 2:SUITE F
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-4127
Mailing Address - Country:US
Mailing Address - Phone:671-649-4501
Mailing Address - Fax:671-649-4507
Practice Address - Street 1:177C CHALAN PASAHERU
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-4127
Practice Address - Country:US
Practice Address - Phone:671-647-6201
Practice Address - Fax:671-647-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GU261Q00000X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
H51436Medicare UPIN