Provider Demographics
NPI:1396934253
Name:GUAM MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:GUAM MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOSPITAL ADMINISTRATOR CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:Q
Authorized Official - Last Name:PEREZ POSADAS
Authorized Official - Suffix:
Authorized Official - Credentials:MN RN
Authorized Official - Phone:671-647-2104
Mailing Address - Street 1:850 GOVERNOR CARLOS CAMACHO ROAD
Mailing Address - Street 2:
Mailing Address - City:OKA TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-3128
Mailing Address - Country:US
Mailing Address - Phone:671-647-2418
Mailing Address - Fax:671-649-5508
Practice Address - Street 1:850 GOVERNOR CARLOS CAMACHO ROAD
Practice Address - Street 2:
Practice Address - City:OKA TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3128
Practice Address - Country:US
Practice Address - Phone:671-647-2104
Practice Address - Fax:671-649-5508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
652300OtherMEDICARE PROVIDER