CENTINELLA STATE PRISON – NPI #1679108476
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 located.

Health Care Provider Taxonomy Code for Pharmacy

CENTINELLA STATE PRISON is a pharmacy located in IMPERIAL, CA. NPPES has assigned the NPI number 1679108476 to CENTINELLA STATE PRISON on March 12, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “CENTINELLA STATE PRISON” is a dba name, the actual legal business name for this organization is CORRECTIONS AND REHABILITATION-HEADQUARTERS. The primary taxonomy selected by this provider is 333600000X from the Health Care Provider Taxonomy code set, which is classified as Pharmacy.

The NPI profile was last updated on Dec 04, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CENTINELLA STATE PRISON below.

NPI Profile for
CORRECTIONS AND REHABILITATION-HEADQUARTERS

NPI Number
1679108476
Enumeration Date

(more than 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CORRECTIONS AND REHABILITATION-HEADQUARTERS
Doing Business As (dba): CENTINELLA STATE PRISON
Primary location
2302 BROWN ROAD
IMPERIAL, CA 92251
Phone: (760) 337-7900 Fax: (760) 482-3006
Mailing address
P.O. BOX 731
IMPERIAL, CA 92251-0731
Phone: (760) 337-7900 Fax: (760) 482-3006
Organization Subpart
Yes - CENTINELLA STATE PRISON is subpart of another organization.
Authorized Official
PIERRE JAMES
STAFF SERVICES MANAGER I
Phone: (510) 780-6997
Updated
Certification Date
Dec 04, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
333600000X
- Pharmacy (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.