Organization · Type 2 NPI

Corrections and Rehabilitation-Headquarters

Pharmacy · Crescent City, CA

NPI number 1053946889 Active

Practice location

5905 Lake Earl Dr
Crescent City, CA 95532-0001

Fax (707) 465-9178

Specialties and licenses

Taxonomy	Code	License
Pharmacy Primary	333600000X	None listed

Pharmacy: A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is lo…

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NPI record

NPI: 1053946889
Entity type: Organization (Type 2)
Issued: Mar 12, 2020
Last updated: Dec 4, 2024
Status: Active
Subpart: Yes of Corrections and Rehabilitation

Other names

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Pelican Bay State Prison Pharmacy · doing business as
Pelican Bay State Prison Pharmacy · doing business as

Authorized official

Pierre Caesare Saucier James
Staff Services Manager I
(510) 780-6997

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1053946889

Corrections and Rehabilitation-Headquarters's National Provider Identifier is 1053946889, issued on Mar 12, 2020. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Crescent City, CA. The record was last updated on Dec 4, 2024.