Adult Health Care Clinic LLC
Organization Active NPI Health Service Clinic/Center · Tamuning, GU
NPI 1578857520 · NPPES record last updated Jan 9, 2023
Key facts
- NPI
- 1578857520
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Service Clinic/Center 261QH0100X
- License
- M-1378 (GU)
- Legal business name
- ADULT HEALTH CARE CLINIC LLC
- Practice address
- 2211 Army Dr Ste 105
Tamuning, GU 96913-1267 - Phone
- (671) 647-5546
- Fax
- (671) 647-5550
- NPI assigned
- Jun 7, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Johnny C Lim, M.D
- Title
- Physician
- Phone
- (671) 647-5546
Practitioners 3
-
Johnny C. Lim, M.D.
-
Edgar M. Magcalas, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GU
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221101002353 | GU | Part B Supplier - Clinic/Group Practice | 7517144785 |
Receives reassigned benefits from 3 practitioners Practice locations: Tamuning, GU |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | M-1378 | GU | Yes |
Addresses
Primary practice location
2211 Army Dr Ste 105
Tamuning, GU 96913-1267
Mailing address
2211 Army Dr Ste 105
Tamuning, GU 96913-1267
Phone (671) 647-5546
Other providers in Tamuning, GU
- Evert Vitorio Abit Abear
- Ac Micro Guam LLC
- Access Medical Transport
- Access Medical, Inc.
- Active Life Chiropractic and Physical Therapy
- Margie A Agahan
- Joleen M Aguon
- Maria Teresa Pereda Aguon
- Diana Aiton
- Ugochukwu E Akoma
All providers in Tamuning, GU · Health Service Clinic/Center in Guam
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.