NPIMap

Organization Active NPI

Clan Corporation

Doing business as dba POLYMEDIC PHARMACY

  • Pharmacist
  • Dededo, GU
National Provider Identifier
1750443446
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCY029 Issued in GU
Legal business name
CLAN CORPORATION
Doing business as
dba POLYMEDIC PHARMACY
Practice address
172 E Buena Vista Ave
Dededo, GU 96929-5367
Phone
(671) 637-9683
Fax
(671) 637-3408
NPI assigned
Dec 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Catherine Maniago Concepcion, PHARMACIST INTERNNPI 1780227819
Title
President
Phone
(671) 637-9683

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PCY029 GU Primary

Addresses

Primary practice location

172 E Buena Vista Ave
Dededo, GU 96929-5367

Mailing address

PO Box 9901
Tamuning, GU 96931-5901
Phone (671) 637-9683

Other names 1

  • dba POLYMEDIC PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

172 E Buena Vista Ave
Dededo, GU 96929
Phone (671) 637-9683

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": "1166227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750443446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9901",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969315901",
            "telephone_number": "671-637-9683",
            "fax_number": "671-637-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 E BUENA VISTA AVE",
            "city": "DEDEDO",
            "state": "GU",
            "postal_code": "969295367",
            "telephone_number": "671-637-9683",
            "fax_number": "671-637-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAN CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CONCEPCION",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "MANIAGO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "671-637-9683",
        "authorized_official_credential": "PHARMACIST INTERN"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GU",
            "license": "PCY029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba POLYMEDIC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dededo, GU

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.