Organization
CLAN CORPORATION
Active
Other names
dba POLYMEDIC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE MANIAGO CONCEPCION PHARMACIST INTERN (PRESIDENT)
(671) 637-9683
Entity
Organization
Contact information
Practice address
172 E BUENA VISTA AVE, DEDEDO, GU 96929-5367
(671) 637-9683
(671) 637-3408
Mailing address
PO BOX 9901, TAMUNING, GU 96931-5901
(671) 637-9683
(671) 637-3408
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCY029
GU
Other
Enumeration date
12/16/2006
Last updated
08/22/2020
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