Provider Demographics
NPI:1740580380
Name:PACIFIC BIOMEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:PACIFIC BIOMEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ESTANISLAO
Authorized Official - Middle Name:K
Authorized Official - Last Name:BENAVENTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:670-288-0566
Mailing Address - Street 1:P.O. BOX 502478
Mailing Address - Street 2:
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-2478
Mailing Address - Country:US
Mailing Address - Phone:670-288-0566
Mailing Address - Fax:670-234-2618
Practice Address - Street 1:#12 PATNITOS LN, ASLITO
Practice Address - Street 2:
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950-2478
Practice Address - Country:US
Practice Address - Phone:670-288-0566
Practice Address - Fax:670-234-2618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier