Active NPI
Teresita Fugoso
- Pharmacist
- Imperial, CA
National Provider Identifier
1104241645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH
- Practice address
- 2302 Brown Rd
Centinela State Prison Pharmacy
Imperial, CA 92251 - Phone
- (760) 337-7624
- Fax
- (760) 482-3006
- NPI assigned
- Feb 20, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH | CA | Primary |
Addresses
Primary practice location
2302 Brown Rd
Centinela State Prison Pharmacy
Imperial, CA 92251
Mailing address
2302 Brown Rd
Centinela State Prison Pharmacy
Imperial, CA 92251
Phone (760) 337-7624
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392854400000",
"number": "1104241645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2302 BROWN RD",
"address_2": "CENTINELA STATE PRISON PHARMACY",
"city": "IMPERIAL",
"state": "CA",
"postal_code": "92251",
"telephone_number": "760-337-7624",
"fax_number": "760-482-3006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2302 BROWN RD",
"address_2": "CENTINELA STATE PRISON PHARMACY",
"city": "IMPERIAL",
"state": "CA",
"postal_code": "92251",
"telephone_number": "760-337-7624",
"fax_number": "760-482-3006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUGOSO",
"first_name": "TERESITA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-20",
"last_updated": "2014-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Imperial, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.