Provider Demographics
NPI:1427069533
Name:TAKECARE INSURANCE COMPANY, INC.
Entity type:Organization
Organization Name:TAKECARE INSURANCE COMPANY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CSG ADMINISTRATOR/CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:LUCIO ALBERTO
Authorized Official - Middle Name:VILLAMAYOR
Authorized Official - Last Name:ALMIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:671-646-6956
Mailing Address - Street 1:PO BOX 6578
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96931-6578
Mailing Address - Country:US
Mailing Address - Phone:671-646-5825
Mailing Address - Fax:671-647-3546
Practice Address - Street 1:548 S MARINE CORPS DR
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3539
Practice Address - Country:US
Practice Address - Phone:671-646-5825
Practice Address - Fax:671-647-3556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GU55053Medicare ID - Type Unspecified