1619217742 NPI number — COMMONWEALTH HEALTHCARE CORPORATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619217742 NPI number — COMMONWEALTH HEALTHCARE CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMONWEALTH HEALTHCARE CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619217742
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 500409
Provider Second Line Business Mailing Address:
LEMMAI WAY KAGMAN II
Provider Business Mailing Address City Name:
SAIPAN
Provider Business Mailing Address State Name:
MP
Provider Business Mailing Address Postal Code:
96950-0409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
670-256-5242
Provider Business Mailing Address Fax Number:
670-256-5244

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 LEMMAI WAY KAGMAN II
Provider Second Line Business Practice Location Address:
BUILDINGS 1 & 2
Provider Business Practice Location Address City Name:
SAIPAN
Provider Business Practice Location Address State Name:
MP
Provider Business Practice Location Address Postal Code:
96950-0409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
670-256-5242
Provider Business Practice Location Address Fax Number:
670-256-5244
Provider Enumeration Date:
02/27/2013

Additional Information

Authorized Official

Authorized Official Last Name:
CASTRO
Authorized Official First Name:
VINCENT
Authorized Official Middle Name:
T
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
670-256-5242

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com