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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