Organization Active NPI

Payless Markets Inc

Doing business as Superdrug Oka

  • Community/Retail Pharmacy
  • Tamuning, GU
National Provider Identifier
1285746107
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PCY034 Issued in GU
Legal business name
PAYLESS MARKETS INC
Doing business as
Superdrug Oka
Practice address
275 Farenholt Ave Ste 208
Tamuning, GU 96913-3217
Phone
(671) 646-6183
Fax
(671) 649-2724
NPI assigned
Aug 31, 2006
Last updated
Feb 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Authorized official

Name
Michael Benito, RPH
Title
Gen MGR
Phone
(671) 477-9266

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PCY034 GU Primary

Addresses

Primary practice location

275 Farenholt Ave Ste 208
Tamuning, GU 96913-3217

Mailing address

275 Farenholt Ave Ste 208
Tamuning, GU 96913-3217

Other identifiers 1

IdentifierTypeStateIssuer
2112066OtherPK

Other names 1

  • SUPERDRUG OKA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220112002707 GU Part B Supplier - Pharmacy 5294127783 Practice locations: Tamuning, GU
O20250214000417 GU DME Supplier - Pharmacy 5294127783 Practice locations: Tamuning, GU

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Superdrug - Oka275 Farenholt Ave Unit 208, Tamuning, GU 96913-3217(671) 646-6159 Automatic Ext Defibrillator (AEDS) and/or Supplies|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Heat & Cold Applications|Infrared Heating Pads Systems and/or Supplies|Neuromuscular Elect Stimulators (NMES)/Supplies|Osteogen… Accepts assignmentParticipating since Dec 1, 2021

National Provider Directory

National Provider Directory
Tax ID family
Superdrug-Harmon4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

275 Farenholt Ave
Ste 208
Tamuning, GU 96913
Phone (671) 646-6159

275 Farenholt Ave
Ste B
Tamuning, GU 96913
Phone (671) 646-6183

285 Farenholt Ave
Ste C4
Tamuning, GU 96913

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1285746107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 FARENHOLT AVE STE 208",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 FARENHOLT AVE STE 208",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133217",
            "telephone_number": "671-646-6183",
            "fax_number": "671-649-2724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAYLESS MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-02-10",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "BENITO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "GEN MGR",
        "authorized_official_telephone_number": "671-477-9266",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GU",
            "license": "PCY034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2112066",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUPERDRUG OKA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tamuning, GU

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.