Preston Youth Correctional Facility

NPI 1033263488 - Pharmacy - 3336I0012X

NPI Details
NPI 1033263488
Enumeration Date 01/23/2007
Last Updated 09/12/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name KENNETH KENNETH
Position PHRM
Phone (209) 274-8275
Fax (209) 274-0865
Practice Location
201 WATERMAN RD
IONE CA, 95640-9701, US
Phone (209) 274-8275
Fax (209) 274-0865
Business Location
201 WATERMAN RD
IONE CA, 95640-9701, US
Phone
Fax
Toxanomy
Taxonomy Code 3336I0012X
License State California
License Number LCF44606
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According to our database, Preston Youth Correctional Facility NPI is 1033263488, taxonomy code is 3336I0012X and license number is LCF44606, license state is located at California. Preston Youth Correctional Facility physically located at 201 Waterman Rd, Ione CA, 95640-9701. NPI Number 1033115704 has the healthcare provider type.

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1033263488 NPI number is provided on an as is basis without warranty of any kind. 1033263488 is maintained by the National Plan & Provider Enumeration System. The contents of Preston Youth Correctional Facility are for informational purposes only.