Organization
CORRECTIONS AND REHABILITATION-HEADQUARTERS
Active
Parent organization
CORRECTIONS AND REHABILITATION
Other names
Neumiller Infirmary Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
CORRECTIONS AND REHABILITATION
Authorized official
PIERRE CAESARE SAUCIER JAMES (STAFF SERVICES MANAGER I)
(510) 780-6997
Entity
Organization
Contact information
Practice address
1 MAIN STREET, SAN QUENTIN, CA 94964
(415) 454-1460
(415) 419-4234
Mailing address
1 MAIN STREET, SAN QUENTIN, CA 94964
(415) 454-1460
(415) 419-4234
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336I0012X
Institutional Pharmacy
17378
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5639212
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/28/2010
Last updated
12/04/2024
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