Active NPI
Payless Markets Inc
Doing business as Superdrug Pharmacy-Agana Payless
- Community/Retail Pharmacy
- Chalan Pago, GU
National Provider Identifier
1619919040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PCY037
- Legal business name
- PAYLESS MARKETS INC
- Doing business as
- Superdrug Pharmacy-Agana Payless
- Practice address
- 302 S Route 4
Ste 118, Agana Shopping Ctr
Chalan Pago, GU 96910 - Phone
- (671) 477-3627
- Fax
- (671) 477-5589
- NPI assigned
- Jun 11, 2006
- Last updated
- Mar 18, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mike Benito, RPH
- Title
- General Manager Payless Mrkts
- Phone
- (671) 477-3627
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PCY037 | GU | Primary |
Addresses
Primary practice location
302 S Route 4
Ste 118, Agana Shopping Ctr
Chalan Pago, GU 96910
Mailing address
302 S Route 4
Ste 118, Agana Shopping Ctr
Chalan Pago, GU 96910
Phone (671) 477-3627
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5410371 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names 1
- SUPERDRUG PHARMACY-AGANA PAYLESS
National Provider Directory
National Provider Directory- Tax ID family
- Payless Markets Inc
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pharmacy
- Dededo, GU
- NPI 1114362571
Locations
302 Route 4
Ste 118
Chalan Pago, GU 96910
Phone (671) 477-3627
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149984000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1363564800000",
"number": "1619919040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 S ROUTE 4",
"address_2": "STE 118, AGANA SHOPPING CTR",
"city": "CHALAN PAGO",
"state": "GU",
"postal_code": "96910",
"telephone_number": "671-477-3627",
"fax_number": "671-477-5589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 S ROUTE 4",
"address_2": "STE 118, AGANA SHOPPING CTR",
"city": "CHALAN PAGO",
"state": "GU",
"postal_code": "96910",
"telephone_number": "671-477-3627",
"fax_number": "671-477-5589"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PAYLESS MARKETS INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-11",
"last_updated": "2013-03-18",
"status": "A",
"authorized_official_last_name": "BENITO",
"authorized_official_first_name": "MIKE",
"authorized_official_title_or_position": "GENERAL MANAGER PAYLESS MRKTS",
"authorized_official_telephone_number": "671-477-3627",
"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": "PCY037",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
"identifier": "5410371",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "SUPERDRUG PHARMACY-AGANA PAYLESS",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Chalan Pago, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.