Provider Demographics
NPI:1245093012
Name:SUPERDRUG TUMON
Entity type:Organization
Organization Name:SUPERDRUG TUMON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:DALMACIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:671-633-3684
Mailing Address - Street 1:404 N MARINE CORPS DR
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-4109
Mailing Address - Country:US
Mailing Address - Phone:671-649-7843
Mailing Address - Fax:671-649-7841
Practice Address - Street 1:404 N MARINE CORPS DR
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-4109
Practice Address - Country:US
Practice Address - Phone:671-649-7843
Practice Address - Fax:671-649-7841
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAYLESS MARKETS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-05
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy