Brabu Pharmacy and Wellness Center LLC
Organization Active NPI Community/Retail Pharmacy · Saipan, MP
NPI 1124269378 · NPPES record last updated Aug 20, 2024
Key facts
- NPI
- 1124269378
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- RP-005 (MP)
- Legal business name
- BRABU PHARMACY AND WELLNESS CENTER LLC
- Practice address
- 101 Akari BLDG CH Pale Arnold Rd
Saipan, MP 96950 - Phone
- (670) 233-2668
- Fax
- (670) 233-2670
- NPI assigned
- Mar 18, 2009
- Organization subpart
- No
Authorized official
- Name
- Theodore Parker, R.PH., MPH
- Title
- Owner
- Phone
- (670) 233-2668
Subparts reporting this organization as parent 3
Corporate family (same tax ID) 3
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 66D2217524 | Brabu Pharmacy and Wellness Center | Certificate of waiver | Mar 21, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Brabu Pharmacy |
Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MP
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250204001385 | MP | Part B Supplier - Pharmacy | 6507396751 | Practice locations: Saipan, MP |
National Provider Directory
- Tax ID family
- Brabu Pharmacy and Wellness
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | RP-005 | MP | Yes |
Addresses
Primary practice location
101 Akari BLDG CH Pale Arnold Rd
Saipan, MP 96950
Mailing address
PO Box 10003
PMB 761
Saipan, MP 96950-8903
Phone (670) 233-2668
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2119463 | Other | PK |
Other names
- Brabu Pharmacy
Other providers in Saipan, MP
- Gino Anthony Diaz Benavente
- Jonalyn Rodriguez Bernardino
- Sydney Lexter N. Biag
- Gayline Patricia Blau
- Leticia Pangelinan Borja
- Brabu Pharmacy and Wellness Center LLC
- Brabu Pharmacy and Wellness Center LLC
- Florian Gustav Adolf Braig
- Adrian Charles Brenn
- Shawna Brennfleck
All providers in Saipan, MP · Community/Retail Pharmacy in Northern Mariana Islands
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.