Provider Demographics
NPI:1760508303
Name:QUINATA, JOSEPH CRUZ (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:CRUZ
Last Name:QUINATA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 TALISAY DR
Mailing Address - Street 2:
Mailing Address - City:SANTA RITA
Mailing Address - State:GU
Mailing Address - Zip Code:96915
Mailing Address - Country:US
Mailing Address - Phone:671-565-2540
Mailing Address - Fax:671-565-3048
Practice Address - Street 1:NORTH ROUTE 2
Practice Address - Street 2:SUITE A106
Practice Address - City:AGAT
Practice Address - State:GU
Practice Address - Zip Code:96928
Practice Address - Country:US
Practice Address - Phone:671-565-3043
Practice Address - Fax:671-565-3048
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUPH024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist