Organization
DETENTION'S FACILITY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE LEICHT (ADMINISTRATOR)
(858) 974-5962
Entity
Organization
Contact information
Practice address
8525 GIBBS DR STE 101, SAN DIEGO, CA 92123-1758
(858) 974-5977
(858) 974-5827
Mailing address
8525 GIBBS DR STE 101, SAN DIEGO, CA 92123-1758
(858) 974-5977
(858) 974-5827
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
BD7140128
CA
Other
Enumeration date
05/24/2007
Last updated
08/22/2020
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