Provider Demographics
NPI:1568083459
Name:TINIAN HEALTH CENTER PHARMACY
Entity Type:Organization
Organization Name:TINIAN HEALTH CENTER PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:MUNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:670-236-8201
Mailing Address - Street 1:PO BOX 500409
Mailing Address - Street 2:
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-0409
Mailing Address - Country:US
Mailing Address - Phone:670-236-8335
Mailing Address - Fax:
Practice Address - Street 1:SAN JOSE VILLAGE
Practice Address - Street 2:
Practice Address - City:TINIAN
Practice Address - State:MP
Practice Address - Zip Code:96952-9695
Practice Address - Country:US
Practice Address - Phone:670-433-9233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMONWEALTH HEALTHCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy