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Contact Information

MARIANO PRIME LIMITED LIABILITY
330 W MARINE CORPS DR
DEDEDO, GU96929-5924
 Phone: 671-632-3385
 Fax: 671-623-3528
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for MARIANO PRIME LIMITED LIABILITY

NPI # 1518003136
LBN Legal business name MARIANO PRIME LIMITED LIABILITY
Authorized official ARTHUR MARIANO - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/30/2007
Last updated 02/21/2017 - About 9 years ago
Identifiers
GU License # PCY040
GU Medicaid 655
Other 2112124 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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