NPIMap

Organization Active NPI

Mariano Prime Limited Liability

Doing business as Mega Drug III

  • Community/Retail Pharmacy
  • Dededo, GU
National Provider Identifier
1255680914
Registry record updated Oct 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PCY055 Issued in GU
Legal business name
MARIANO PRIME LIMITED LIABILITY
Doing business as
Mega Drug III
Practice address
2042 Army Dr
Dededo, GU 96929-6516
Phone
(671) 646-5355
Fax
(671) 646-5333
NPI assigned
Sep 10, 2012
Last updated
Oct 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2013

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

Authorized official

Name
Arthur MarianoNPI 1457673667
Title
R.PH. / President
Phone
(671) 646-5355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X PCY055 GU Primary

Addresses

Primary practice location

2042 Army Dr
Dededo, GU 96929-6516

Mailing address

2042 Army Dr
Dededo, GU 96929-6516
Phone (671) 646-5355

Other identifiers 1

IdentifierTypeStateIssuer
2136841OtherPK

Other names 1

  • MEGA DRUG III Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mariano Prime LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

2042 Army Dr
Dededo, GU 96929
Phone (671) 646-5355

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381449600000",
    "number": "1255680914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2042 ARMY DR",
            "city": "DEDEDO",
            "state": "GU",
            "postal_code": "969296516",
            "telephone_number": "671-646-5355",
            "fax_number": "671-646-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2042 ARMY DR",
            "city": "DEDEDO",
            "state": "GU",
            "postal_code": "969296516",
            "telephone_number": "671-646-5355",
            "fax_number": "671-646-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIANO PRIME LIMITED LIABILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-10",
        "last_updated": "2013-10-11",
        "status": "A",
        "authorized_official_last_name": "MARIANO",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_title_or_position": "R.PH. / PRESIDENT",
        "authorized_official_telephone_number": "671-646-5355"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GU",
            "license": "PCY055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2136841",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEGA DRUG III",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dededo, GU

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2013; 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.