Organization
TAKECARE INSURANCE COMPANY, INC.
Active
Other names
FHP Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD H. FETHERMAN (EXEC VP CFO)
(671) 646-6956
Entity
Organization
Contact information
Practice address
548 SOUTH MARINE CORPS DRIVE, TAMUNING, GU 96913
(671) 646-5824
(671) 647-3546
Mailing address
PO BOX 6578, TAMUNING, GU 96931-6578
(671) 646-6956
(671) 647-3546
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCY005
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5428948
NCPDP #
GU
Enumeration date
12/29/2006
Last updated
08/22/2020
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