CORRECTIONS AND REHABILITATION (NPI# 1376190876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376190876 |
| Entity Type | Organization |
| Organization Name | CORRECTIONS AND REHABILITATION |
| Other Organization Name | CORCORAN STATE PRISON HOSPITAL PHARMACY |
| Practice Address |
4001 King Avenue Corcoran CA 93212 |
| Practice Telephone | 5599928800 |
| Practice Fax Number | 5599927381 |
| Mailing Telephone | 5599928800 |
| Mailing Fax Number | 5599927381 |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2020-03-18 |
| Authorized Official Name | DR. ROBERT STEVEN THARRATT (STATEWIDE CHIEF MEDICAL EXECUTIVE) |
| Authorized Official Telephone | 9166919913 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | CORRECTIONS AND REHABILITATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CORCORAN STATE PRISON HOSPITAL PHARMACY | BC3615222 | 01 |
| Other Name | Type Code |
|---|---|
| Corcoran State Prison Hospital Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578199741 | Corrections and Rehabilitation | Pharmacy | 16756 Chino Corona Road, Corona, CA 92880 | 2020-03-19 |
| 1275169005 | Corrections and Rehabilitation | Pharmacy | 481 Alta Road, Facility E, Facility Support Building, Room A161, San Diego, CA 92179 | 2020-03-12 |
| 1265067086 | Corrections and Rehabilitation | Pharmacy | 7018 Blair Road, Calipartia, CA 92233 | 2020-03-12 |
| 1134754955 | Corrections and Rehabilitation | Pharmacy | 22844 Virginia Blvd., California City, CA 93505 | 2020-03-12 |
| 1831724657 | Corrections and Rehabilitation | Pharmacy | 570 E. Natoma Street, Folsom, CA 95630 | 2020-03-12 |
| 1427684257 | Corrections and Rehabilitation | Pharmacy | 24863 W. Jayne Avenue, Coalinga, CA 93210 | 2020-03-12 |
| 1356976179 | Corrections and Rehabilitation | Pharmacy | 19005 Wileys Well Road, Blythe, CA 92225 | 2020-03-12 |
| 1326673146 | Corrections and Rehabilitation | Pharmacy | 23500 Kasson Rd Rm 180, Tracy, CA 95304-9595 | 2020-03-12 |
| 1528694379 | Corrections and Rehabilitation | Pharmacy | 21633 Avenue 24 Bldg 1101 Rm 173, Chowchilla, CA 93610-0099 | 2020-03-12 |
| 1417583287 | Corrections and Rehabilitation | Pharmacy | 31626 Highway 101 Dmh Administration Ste 606, Soledad, CA 93960-1020 | 2020-03-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CORRECTIONS AND REHABILITATION, DEPARTMENT OF | 560 E Natoma St, Folsom, CA 95630-2233 |
| Street Address |
4001 KING AVENUE |
| City | CORCORAN |
| State | CA |
| Zip Code | 93212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821274705 | William Edward Mekeel | Dentist | 4001 King Avenue, Corcoran, CA 93212-8800 | 2008-01-10 |
| 1841460805 | John R Francois | Social Worker | 4001 King Avenue, Corcoran, CA 93212-8800 | 2008-03-06 |
| 1932399979 | Josephine C Bondoc | Nurse Practitioner | 4001 King Avenue, California State Prison, Corcoran, CA 92312 | 2007-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841746583 | Luis Alvarez | Specialist/Technologist | 1000 Alder Ave, Corcoran, CA 93212 | 2016-09-01 |
| 1881893667 | William Joseph Mcguinness | Internal Medicine | 4001 W. King Ave, Corcoran, CA 93212 | 2007-07-12 |
| 1265576912 | Kings View Counseling Services for Kings Count | Community/Behavioral Health | 1002 Dairy Avenue, Corcoran, CA 93212 | 2007-02-16 |
| 1255480406 | John Vernon Dale Richardson | Dentist | 1409 Whitley Ave, Suite D, Corcoran, CA 93212 | 2007-01-09 |
| 1093748923 | Michael Alan Ross | Physician Assistant | 900 Quebec, Corcoran, CA 93212 | 2006-07-07 |
| 1407460454 | Tiffany Jean Sparks-mendoza | Social Worker | 4001 King Ave., Corcoran, CA 93212 | 2020-09-06 |
| 1639507825 | Benjamin J Adam | Psychologist | 4001 King Ave, Corcoran, CA 93212 | 2013-10-24 |
| 1427317700 | Carolyn Virginia Bola | Psychologist | 4001 King Ave, Corcoran, CA 93212 | 2012-05-08 |
| 1629379367 | Rachel Simmi Jerdin | Social Worker | 900 Quebec Ave, Corcoran, CA 93212 | 2010-11-11 |
| 1982928016 | Caitlin Chinn-goshgarian | Psychologist | 900 Quebec Avenue, Corcoran, CA 93212 | 2010-03-18 |
| Find all providers in zip 93212 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144240904 | Aycc Pharmacy Inc | Pharmacy | 1115 Whitley Ave, Corcoran, CA 93212-2325 | 2006-07-21 |
| 1588290654 | Corrections and Rehabilitation | Pharmacy | 900 Quebec Avenue, Corcoran, CA 93212-7100 | 2020-03-20 |
| 1568004174 | California Substance Abuse Treatment Facility-state Prison | Pharmacy | 900 Quebec Ave, Corcoran, CA 93212-9715 | 2019-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528940 | Kaiser Foundation Health Plan Inc | Pharmacy | 4647 Zion Ave Fl4, Rm 4825, San Diego, CA 92120-2507 | 2020-11-06 |
| 1891394128 | Scriptdash Inc | Pharmacy | 4240 Kearny Mesa Rd Ste 107, San Diego, CA 92111-3769 | 2020-10-19 |
| 1235736737 | Scriptdash Inc | Pharmacy | 2360 Qume Dr, San Jose, CA 95131-1838 | 2020-10-07 |
| 1023615150 | Kaiser Foundation Health Plan Inc | Pharmacy | 9550 Escondido Ave Fl 1, Rm 1100, Hesperia, CA 92345-9120 | 2020-10-01 |
| 1033725478 | Happy Med Inc. | Pharmacy | 210 S Grand Ave Ste 116, Glendora, CA 91741-4262 | 2020-09-21 |
| 1366058794 | Joanna Jongae Kim | Pharmacy | 1020 S Anaheim Blvd Ste 101, Anaheim, CA 92805-5807 | 2020-09-21 |
| 1114532231 | Prime Rx San Gabriel, Inc. | Pharmacy | 533 W Las Tunas Dr # 102, San Gabriel, CA 91776-1133 | 2020-09-15 |
| 1164034260 | Tin Rx At The Tower Inc. | Pharmacy | 1801 Colorado Ave Ste 300, Turlock, CA 95382-2708 | 2020-08-19 |
| 1144831702 | Cameron Michael Rehmani Seraji | Pharmacy | 10542 Villa Del Cerro, Santa Ana, CA 92705-1486 | 2020-08-16 |
| 1881204907 | Kaiser Foundation Health Plan Inc | Pharmacy | 25821 S Vermont Ave Fl 4, Rm 4049, Harbor City, CA 90710-3518 | 2020-08-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.