Provider Demographics
NPI:1457521429
Name:LUCIA S. CORPUZ
Entity Type:Organization
Organization Name:LUCIA S. CORPUZ
Other - Org Name:MARIANAS MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUCIA
Authorized Official - Middle Name:SALAS
Authorized Official - Last Name:CORPUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:670-233-6671
Mailing Address - Street 1:PMB 737 BOX 10003
Mailing Address - Street 2:GUALO RAI
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-0000
Mailing Address - Country:US
Mailing Address - Phone:670-233-6671
Mailing Address - Fax:670-233-6672
Practice Address - Street 1:M & H BUILDING
Practice Address - Street 2:GUALO RAI
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950-0000
Practice Address - Country:US
Practice Address - Phone:670-233-6671
Practice Address - Fax:670-233-6672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MP6068970001Medicare NSC