Organization
MARIANO PRIME LIMITED LIABILITY
Active
Other names
MEGA DRUG II
Organization subpart
No
Provider details
NPI number
Authorized official
ARTHUR MARIANO (OWNER)
(671) 646-0020
Entity
Organization
Contact information
Practice address
330 W MARINE CORPS DR, DEDEDO, GU 96929-5924
(671) 632-3385
(671) 623-3528
Mailing address
255 FARENHOLT AVE, TAMUNING, GU 96913-3209
(671) 632-3385
(671) 623-3528
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PCY040
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2112124
PK
—
05
—
655
—
GU
Enumeration date
01/30/2007
Last updated
02/21/2017
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