Organization
PAYLESS MARKETS INC
Active
Other names
SUPERDRUG PHARMACY-AGANA PAYLESS
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE BENITO RPH (GENERAL MANAGER PAYLESS MRKTS)
(671) 477-3627
Entity
Organization
Contact information
Practice address
302 S ROUTE 4, STE 118, AGANA SHOPPING CTR, CHALAN PAGO, GU 96910
(671) 477-3627
(671) 477-5589
Mailing address
302 S ROUTE 4, STE 118, AGANA SHOPPING CTR, CHALAN PAGO, GU 96910
(671) 477-3627
(671) 477-5589
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PCY037
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5410371
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/11/2006
Last updated
03/18/2013
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