Superdrug Tumon

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SUPERDRUG TUMON

Practice address

404 N Marine Corps Dr
Tamuning, GU 96913-4109

Phone

(671) 649-7843

Fax

(671) 649-7841

NPI assigned

Feb 5, 2024

Organization subpart

Yes

Parent organization

PAYLESS MARKETS INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paul DalmacioNPI 1376198317

Title

Pharmacy Manager

Phone

(671) 633-3684

Specialties & licenses 1

Addresses

Tax ID family

Superdrug-Yigo2 organizations share this tax ID, including this one

Part of

Superdrug-Yigo

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Superdrug-Yigo

  • Pharmacy
  • Yigo, GU
  • NPI 1306304837
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul Dalmacio

  • Pharmacist
  • Dededo, GU
  • NPI 1376198317
  NPD Authorized official
• Rosae Camarin Shandor, R.D.N.

  • Registered Dietitian
  • Hagatna, GU
  • NPI 1700342946
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1245093012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 N MARINE CORPS DR",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134109",
            "telephone_number": "671-649-7843",
            "fax_number": "671-649-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N MARINE CORPS DR",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134109",
            "telephone_number": "671-649-7843",
            "fax_number": "671-649-7841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERDRUG TUMON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PAYLESS MARKETS INC",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "DALMACIO",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "671-633-3684"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Renae Sukola, M.A., I.M.F.T.
• Hugh Sule, DDS
• John Sullivan, D.D.S.
• Kevin John Sullivan, CRNA
• Ariel Sumbo, RN
• Collette Elke Supit, D.D.S.
• Edwin Jess Supit, M.D.
• Deborah Ann Swena, M.D.
• Sheri Lynne Tackett, APRN-CNP
• Patricia Leon Guerrero Taimanglo, PHD

• All providers in Tamuning, GU
• Community/Retail Pharmacy in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.