Provider Demographics
NPI:1588208862
Name:MMC & PACIFIC LABS, LLC
Entity Type:Organization
Organization Name:MMC & PACIFIC LABS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:VILLANUEVA
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:670-234-3926
Mailing Address - Street 1:PO BOX 5006
Mailing Address - Street 2:
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-5006
Mailing Address - Country:US
Mailing Address - Phone:670-234-3926
Mailing Address - Fax:670-234-3950
Practice Address - Street 1:JKR BUILDING BEACH ROAD GARAPAN
Practice Address - Street 2:
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950-9695
Practice Address - Country:US
Practice Address - Phone:670-285-1401
Practice Address - Fax:670-234-3926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty