MARTINEZ DETENTION FACILITY PHARMACY
Custodial Care Facility
Martinez, California
Provider NPI: 1750584900
Organization Information:Organization Name: MARTINEZ DETENTION FACILITY PHARMACY
Practice Location:
1000 WARD ST MARTINEZ, CA 94553 US
Tel: 925-335-4712 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
1000 WARD ST MARTINEZ, CA 94553 US
Tel: 925-335-4712 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311Z00000X | Nursing & Custodial Care Facilities Custodial Care Facility | CA | LCF36620 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
STATE LICENCE NUMBER | LCF36620 | CA | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin