NPIMap

Organization Active NPI

Jake Enterprises Inc

  • Community/Retail Pharmacy
  • Tamuning, GU
National Provider Identifier
1962540955
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PCY042 Issued in GU
Legal business name
JAKE ENTERPRISES INC
Practice address
1244 N Marine Corps Dr
Tamuning, GU 96913-4308
Phone
(671) 646-6515
Fax
(671) 646-6516
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Authorized official

Name
Marilyn Florendo, RPH
Title
Managing Pharmacist
Phone
(671) 646-6515

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X PCY042 GU Primary

Addresses

Primary practice location

1244 N Marine Corps Dr
Tamuning, GU 96913-4308

Mailing address

1244 N Marine Corps Dr
Tamuning, GU 96913-4308
Phone (671) 646-6515

Other identifiers 1

IdentifierTypeStateIssuer
5411842OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • COMMUNITY PHARMACY II 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": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317772800000",
    "number": "1962540955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 N MARINE CORPS DR",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134308",
            "telephone_number": "671-646-6515",
            "fax_number": "671-646-6516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 N MARINE CORPS DR",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134308",
            "telephone_number": "671-646-6515",
            "fax_number": "671-646-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAKE ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2011-10-05",
        "status": "A",
        "authorized_official_last_name": "FLORENDO",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "MANAGING PHARMACIST",
        "authorized_official_telephone_number": "671-646-6515",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GU",
            "license": "PCY042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5411842",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY PHARMACY II",
            "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 Oct 5, 2011; 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.