Organization
GOVERNMENT OF GUAM DEPARTMENT OF ADMINISTRATION
Active
Other names
Southern Region Community Health Center Pharmacy (SRCHC)
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE DELOSO RPH (PHARMACY MANAGER)
(671) 635-7447
Entity
Organization
Contact information
Practice address
162 AS ABMAN DR, INARAJAN, GU 96917
(671) 828-7547
(671) 828-7504
Mailing address
123 CHALAN KARETA, MANGILAO, GU 96913-6304
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PCY011
GU
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2112062
PK
—
05
—
636
—
GU
Enumeration date
11/14/2006
Last updated
09/28/2016
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