NPIMap

Organization Active NPI

Jake Enterprises Inc

Doing business as Community Pharmacy I

  • Clinic Pharmacy
  • Tamuning, GU
National Provider Identifier
1548397128
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
PCY039 Issued in GU
Legal business name
JAKE ENTERPRISES INC
Doing business as
Community Pharmacy I
Practice address
177 Chalan Pasaheru Ste C
Tamuning, GU 96913-4161
Phone
(671) 646-6160
Fax
(671) 646-6159
NPI assigned
Feb 28, 2007
Last updated
Jan 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Authorized official

Name
June Aggabao, RPH
Title
Owner Pres and Managing Pharm
Phone
(671) 646-6160

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X PCY039 GU Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

177 Chalan Pasaheru Ste C
Tamuning, GU 96913-4161

Mailing address

177 Chalan Pasaheru Ste C
Tamuning, GU 96913-4161
Phone (671) 646-6160

Other identifiers 1

IdentifierTypeStateIssuer
5411400OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • COMMUNITY PHARMACY I Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Pharmacy I3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325721600000",
    "number": "1548397128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 CHALAN PASAHERU STE C",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134161",
            "telephone_number": "671-646-6160",
            "fax_number": "671-646-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 CHALAN PASAHERU STE C",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134161",
            "telephone_number": "671-646-6160",
            "fax_number": "671-646-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAKE ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2012-01-05",
        "status": "A",
        "authorized_official_last_name": "AGGABAO",
        "authorized_official_first_name": "JUNE",
        "authorized_official_title_or_position": "OWNER PRES AND MANAGING PHARM",
        "authorized_official_telephone_number": "671-646-6160",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "GU",
            "license": "PCY039",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5411400",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY PHARMACY I",
            "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 Jan 5, 2012; 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.