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Contact Information

PRESTON YOUTH CORRECTIONAL FACILITY
201 WATERMAN RD
IONE, CA95640-9701
 Phone: 209-274-8275
 Fax: 209-274-0865
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PRESTON YOUTH CORRECTIONAL FACILITY

NPI Number 1033263488
LBN Legal business name PRESTON YOUTH CORRECTIONAL FACILITY
Authorized official KENNETH ERLEBUSCH - (PHRM)
Entity Organization
Organization subpart 1 No
Enumeration date 01/23/2007
Last updated 09/12/2007 - About 19 years ago
Identifiers
CA License # LCF44606
Other 5625174 OTHER ID NUMBER
Other 5625174 OTHER ID NUMBER-COMMERCIAL NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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