Provider Demographics
NPI:1104671726
Name:PANGILINAN, ROEN GENEEL MANALO (PHARMD)
Entity type:Individual
Prefix:MISS
First Name:ROEN GENEEL
Middle Name:MANALO
Last Name:PANGILINAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 CHALAN BALAKO
Mailing Address - Street 2:PMB 823
Mailing Address - City:DEDEDO
Mailing Address - State:GU
Mailing Address - Zip Code:96929-7103
Mailing Address - Country:US
Mailing Address - Phone:671-898-5646
Mailing Address - Fax:
Practice Address - Street 1:138 KAYEN CHANDO
Practice Address - Street 2:
Practice Address - City:DEDEDO
Practice Address - State:GU
Practice Address - Zip Code:96929-5900
Practice Address - Country:US
Practice Address - Phone:671-632-8100
Practice Address - Fax:671-922-3000
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUPH0561183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist