JAKE ENTERPRISES INC (NPI# 1548397128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548397128 |
| Entity Type | Organization |
| Organization Name | JAKE ENTERPRISES INC |
| Other Organization Name | COMMUNITY PHARMACY I |
| Practice Address |
177 Chalan Pasaheru Ste C Tamuning GU 96913-4161 |
| Practice Telephone | 6716466160 |
| Practice Fax Number | 6716466159 |
| Mailing Telephone | 6716466160 |
| Mailing Fax Number | 6716466159 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2012-01-05 |
| Authorized Official Name | JUNE AGGABAO (OWNER PRES AND MANAGING PHARM) |
| Authorized Official Telephone | 6716466160 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
PCY039 | GU | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 5411400 | 01 |
| Other Name | Type Code |
|---|---|
| COMMUNITY PHARMACY I | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841338506 | Jake Enterprises Inc | Pharmacy | 612 W Marine Corps Dr, Ste 8 Calvo's Bldg, Dededo, GU 96929-5629 | 2007-02-02 |
| 1962540955 | Jake Enterprises Inc | Pharmacy | 1244 N Marine Corps Dr, Tamuning, GU 96913-4308 | 2007-02-02 |
| Street Address |
177 CHALAN PASAHERU STE C |
| City | TAMUNING |
| State | GU |
| Zip Code | 96913-4161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255484275 | Florencio T. Lizama | Specialist | 177 Chalan Pasaheru Ste C, Tamuning, GU 96913-4161 | 2007-01-21 |
| 1861718991 | Emily Ruth Mcdonnell | Pediatrics | 177 Chalan Pasaheru Ste C, Tamuning, GU 96913-4161 | 2010-04-14 |
| 1104060839 | Primary Multispecialty Clinic | Clinic/Center | 177 Chalan Pasaheru Ste C, Tamuning, GU 96913-4161 | 2009-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871126219 | Hannah Marie Sabo Laney | Behavior Technician | 212 Farenholt Ave., Tamuning, GU 96913 | 2020-02-13 |
| 1720618499 | Jacquelin Gouniai | Counselor | 121 North Sabana Drive Detcha Court, Barrigada Heights, GU 96913 | 2020-01-22 |
| 1205475753 | Gabriela Victoria Perez | Behavior Technician | 212 Farenholt Ave, Tamuning, GU 96913 | 2020-01-02 |
| 1073154944 | Quenie-mei Tuliao Fisher | Pharmacist | 790 Governor Carlos Camacho Rd, Tamuning, GU 96913 | 2019-10-02 |
| 1366090698 | Elizabeth Rabon | Technician | 251 Carnation Ave, Mangilao, GU 96913 | 2019-08-29 |
| 1467000299 | Yun Ming Lin | Pharmacist | 850 Gov. Carlos Camacho Street, Tamuning, GU 96913 | 2019-08-26 |
| 1902465354 | Anthony John Litwinchuk Jr. | Audiologist | Usnh Guam - Audiology Department, Bldg #50 Farenholt Ave, Agana Heights, GU 96913 | 2019-06-10 |
| 1124580600 | Khkn Corporation | Acupuncturist | 817 N Marine Corps Dr 109, Tamuning, GU 96913 | 2019-04-03 |
| 1700346541 | Amc Mental Health, LLC | Marriage & Family Therapist | 263 Vietnam Veterans Highway, Mangilao, GU 96913 | 2019-03-20 |
| 1295292365 | Jhaymie Lynn Salarzon Bejerana | Behavior Technician | Building 1350 #216, Upper Tumon, GU 96913 | 2019-02-26 |
| Find all providers in zip 96913 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053470955 | Vik Management, Inc. | Pharmacy | 590 S Marine Dr Ste 126, Tamuning, GU 96913-3531 | 2006-12-06 |
| 1407407737 | Mariano Prime LLC | Pharmacy | 548 S Marine Corps Dr, Tamuning, GU 96913-3539 | 2019-09-27 |
| 1285283382 | Mariano Prime LLC | Pharmacy | 548 S Marine Corps Dr, Tamuning, GU 96913-3539 | 2019-09-11 |
| 1962540955 | Jake Enterprises Inc | Pharmacy | 1244 N Marine Corps Dr, Tamuning, GU 96913-4308 | 2007-02-02 |
| 1336200930 | Vik Management, Inc. | Pharmacy | 416 Chalan San Antonio, Tamuning, GU 96913-3601 | 2006-12-13 |
| 1346314747 | General Conference Corp of Sda | Pharmacy | 388 Ypao Rd, Tamuning, GU 96913-3701 | 2006-11-17 |
| 1427069921 | Takecare Ins Co Inc | Pharmacy | 548 S Marine Corps Dr, Tamuning, GU 96913-3539 | 2006-08-10 |
Please comment or provide details below to improve the information on JAKE ENTERPRISES INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.