# ALAMEDA HEALTH SYSTEM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** JOHN GEORGE PSYCHIATRIC PAVILLION PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114083482
- **Authorized official:** MARTHA YASAVOLIAN (DIR OF PHCY)
- **Authorized official phone:** (510) 437-5055

## Contact information

- **Practice address:** 2060 FAIRMONT DR, SAN LEANDRO, CA 94578-1001
- **Practice address phone:** (510) 346-1454
- **Practice address fax:** (510) 614-9516
- **Mailing address:** 2060 FAIRMONT DR, SAN LEANDRO, CA 94578-1001
- **Mailing address phone:** (510) 346-1454
- **Mailing address fax:** (510) 614-9516

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | HPE37659 | CA | Yes |

## Other

- **Enumeration date:** 12/29/2006
- **Last updated:** 09/13/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2043541 | PK | — |
| 05 | — | PHB356020 | — | CA |