Provider Demographics
NPI:1932329802
Name:GUAM MEDICAL CARE, LLC
Entity Type:Organization
Organization Name:GUAM MEDICAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:PERPETUA
Authorized Official - Last Name:GALGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:671-647-4174
Mailing Address - Street 1:744 NORTH MARINE DRIVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:TAMUNING
Mailing Address - State:GUAM
Mailing Address - Zip Code:96913
Mailing Address - Country:UM
Mailing Address - Phone:671-647-4174
Mailing Address - Fax:671-647-4199
Practice Address - Street 1:744 N MARINE DR
Practice Address - Street 2:SUITE 105
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-4426
Practice Address - Country:US
Practice Address - Phone:671-647-4174
Practice Address - Fax:671-647-4199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GU13-200600396-001261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GU=========OtherEIN NUMBER