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Organization

PAYLESS MARKETS INC

Active
Other names
SUPERDRUG PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL BENITO RPH (GEN MGR)
(671) 477-9266
Entity
Organization

Contact information

Practice address
214 W MARINE CORPS DR, RTE 1, DEDEDO, GU 96929-5913
(671) 637-9783
(671) 637-9747
Mailing address
214 W MARINE CORPS DR, RTE 1, DEDEDO, GU 96929-5913
(671) 637-9783
(671) 637-9747

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PCY026
GU

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1467564385
GU
01
5410155
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
08/31/2006
Last updated
03/18/2013
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