Organization · Type 2 NPI

Corrections and Rehabilitation-Headquarters

Pharmacy · Vacaville, CA

NPI number 1124648712 Active

Practice location

2100 Peabody Road
Vacaville, CA 95687

Call (707) 451-0182 Map

Fax (707) 454-3400

Mailing address

P.o. Box 4000
Vacaville, CA 95696-4000

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…

4 other providers at this address

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NPI record

NPI: 1124648712
Entity type: Organization (Type 2)
Issued: Apr 23, 2020
Last updated: Dec 4, 2024
Status: Active
Subpart: Yes of Corrections and Rehabilitation

Other names

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California State Prison Pharmacy · doing business as
California 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 1124648712

Corrections and Rehabilitation-Headquarters's National Provider Identifier is 1124648712, issued on Apr 23, 2020. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Vacaville, CA. The record was last updated on Dec 4, 2024.