Organization
JAKE ENTERPRISES INC
Active
Organization
JAKE ENTERPRISES INC
Active
Other names
COMMUNITY PHARMACY II
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN FLORENDO RPH (MANAGING PHARMACIST)
(671) 646-6515
Entity
Organization
Contact information
Practice address
1244 N MARINE CORPS DR, TAMUNING, GU 96913-4308
(671) 646-6515
(671) 646-6516
Mailing address
1244 N MARINE CORPS DR, TAMUNING, GU 96913-4308
(671) 646-6515
(671) 646-6516
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PCY042
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5411842
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/02/2007
Last updated
10/05/2011
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