Provider Demographics
NPI:1861434920
Name:PACIFIC MEDICAL CENTER, INC
Entity type:Organization
Organization Name:PACIFIC MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SOLEDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMACHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:670-233-8100
Mailing Address - Street 1:PO BOX 501908
Mailing Address - Street 2:
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-1908
Mailing Address - Country:US
Mailing Address - Phone:670-233-8100
Mailing Address - Fax:670-233-8102
Practice Address - Street 1:PMC BUILDING, MIDDLE ROAD
Practice Address - Street 2:GUALO RAI
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950-1908
Practice Address - Country:US
Practice Address - Phone:670-233-8100
Practice Address - Fax:670-233-8102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MP621111261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MP1861434920OtherMEDICARE NATIONAL PROVIDER IDENTIFIER (NPI)
MP1861434920OtherMEDICARE NATIONAL PROVIDER IDENTIFIER (NPI)