Provider Demographics
NPI:1497401707
Name:SAELUA MEDICAL CORPORATION
Entity Type:Organization
Organization Name:SAELUA MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIROOZMANDI
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:684-256-8650
Mailing Address - Street 1:PO BOX 5799
Mailing Address - Street 2:
Mailing Address - City:PAGO PAGO
Mailing Address - State:AS
Mailing Address - Zip Code:96799-5799
Mailing Address - Country:US
Mailing Address - Phone:684-256-3942
Mailing Address - Fax:
Practice Address - Street 1:5799 TAFUNA INDUSTRIAL PARK
Practice Address - Street 2:BLDG #3
Practice Address - City:PAGO PAGO
Practice Address - State:AS
Practice Address - Zip Code:96799-5799
Practice Address - Country:US
Practice Address - Phone:684-256-3942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No291U00000XLaboratoriesClinical Medical Laboratory
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy