# JAKE ENTERPRISES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** COMMUNITY PHARMACY III
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841338506
- **Authorized official:** JUNE AGGABAO RPH (OWNER PRES AND MANAGING PHARM)
- **Authorized official phone:** (671) 646-6515

## Contact information

- **Practice address:** 612 W MARINE CORPS DR, STE 8 CALVO'S BLDG, DEDEDO, GU 96929-5629
- **Practice address phone:** (671) 637-3323
- **Practice address fax:** (671) 637-3316
- **Mailing address:** 612 W MARINE CORPS DR, STE 8 CALVO'S BLDG, DEDEDO, GU 96929-5629
- **Mailing address phone:** (671) 637-3323
- **Mailing address fax:** (671) 637-3316

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0002X | Clinic Pharmacy | PCY046 | GU | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 02/02/2007
- **Last updated:** 02/11/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2112136 | PK | — |