Provider Demographics
NPI:1376217331
Name:MEDPHARM
Entity Type:Organization
Organization Name:MEDPHARM
Other - Org Name:PRO-CARE HOME-HEALTH SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS DEVELOPMENT OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:671-632-6000
Mailing Address - Street 1:PO BOX 11864
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96931-1864
Mailing Address - Country:US
Mailing Address - Phone:671-632-6000
Mailing Address - Fax:671-632-9000
Practice Address - Street 1:138 KAYEN CHANDO LOT 5
Practice Address - Street 2:
Practice Address - City:DEDEDO
Practice Address - State:GU
Practice Address - Zip Code:96929-5900
Practice Address - Country:US
Practice Address - Phone:671-632-6000
Practice Address - Fax:671-632-9000
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDPHARM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-04
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies