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Organization

MARIANO PRIME LLC

Active
Parent organization
MARIANO PRIME LLC
Other names
MD Wholesale
Organization subpart
Yes

Provider details

NPI number
Legal business name
MARIANO PRIME LLC
Authorized official
MR. MARK SURLA MARIANO (GENERAL MANAGER)
(671) 649-5833
Entity
Organization

Contact information

Practice address
255 FARENHOLT AVE, TAMUNING, GU 96913-3209
(671) 649-5833
(671) 649-5830
Mailing address
255 FARENHOLT AVE, TAMUNING, GU 96913-3209
(671) 649-5833
(671) 649-5830

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Enumeration date
03/12/2012
Last updated
03/12/2012
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