Organization
MARTINEZ DETENTION FACILITY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY TAM (PHARMACIST)
(925) 335-4712
Entity
Organization
Contact information
Practice address
1000 WARD ST, MARTINEZ, CA 94553-1360
(925) 335-4712
(925) 335-4716
Mailing address
1000 WARD ST, MARTINEZ, CA 94553-1360
(925) 335-4712
(925) 335-4716
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
LCF36620
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCF36620
STATE LICENCE NUMBER
CA
Enumeration date
06/06/2007
Last updated
08/22/2020
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