Paul Dalmacio
Individual provider Active NPI Pharmacist · Dededo, GU
NPI 1376198317 · NPPES record last updated Aug 6, 2019
Key facts
- NPI
- 1376198317
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PH-075 (GU)
- Practice address
- 655 Harmon Loop Rd Ste 108
Dededo, GU 96929-6544 - Phone
- (671) 633-3684
- Fax
- (671) 633-3680
- NPI assigned
- Aug 6, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH-075 | GU | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Superdrug Tumon | Current | Accepting new patients | |
| Superdrug-Yigo | Current | Accepting new patients |
Locations
655 Harmon Loop Rd
Ste 108
Dededo, GU 96929
Phone (671) 633-4447
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH-075 | GU | Yes |
Addresses
Primary practice location
655 Harmon Loop Rd Ste 108
Dededo, GU 96929-6544
Mailing address
PO Box 9644
Tamuning, GU 96931-5644
Phone (671) 633-3684
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PH075 | Other | GU | LICENSE NUMBER |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://www.paylessmarkets.com/ |
Other providers in Dededo, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.