Mule Creek Sate Prison

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

LCF35817 Issued in CA

Legal business name

MULE CREEK SATE PRISON

Practice address

9266 Dairy CT
Elk Grove, CA 95624-3583

Phone

(209) 274-4911

NPI assigned

Oct 10, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David Smiley

Title

Ceo

Phone

(209) 274-4911

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mourine Ndamukong

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Elk Grove, CA
  • NPI 1972908887
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412899200000",
    "number": "1730583311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9266 DAIRY CT",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956243583",
            "telephone_number": "209-274-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9266 DAIRY CT",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956243583",
            "telephone_number": "209-274-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULE CREEK SATE PRISON",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-10",
        "last_updated": "2014-10-10",
        "status": "A",
        "authorized_official_last_name": "SMILEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-274-4911",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "LCF35817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MPD Care Mobility Services, LLC
• Rosemary Muchiri
• Jake Muckey
• Evelyne Mugo, RN
• Maryimmaculate Muiruri
• Dennis Rashad Mundy
• Bianca Munguia
• Daisy Munguia
• Aileen Docena Munoz, PHARM.D.
• Angelica Josphine Munoz

• Exclusive Provider Organization in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Exclusive Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.

Verify at the official NPI Registry.