NPIMap

Organization Active NPI

Martinez Detention Facility Pharmacy

  • Custodial Care Facility
  • Martinez, CA
National Provider Identifier
1750584900
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Custodial Care FacilityTaxonomy code 311Z00000X
License
LCF36620 Issued in CA
Legal business name
MARTINEZ DETENTION FACILITY PHARMACY
Practice address
1000 Ward St
Martinez, CA 94553-1360
Phone
(925) 335-4712
Fax
(925) 335-4716
NPI assigned
Jun 6, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Timothy Tam
Title
Pharmacist
Phone
(925) 335-4712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Custodial Care Facility 311Z00000X LCF36620 CA Primary

Addresses

Primary practice location

1000 Ward St
Martinez, CA 94553-1360

Mailing address

1000 Ward St
Martinez, CA 94553-1360
Phone (925) 335-4712

Other identifiers 1

IdentifierTypeStateIssuer
LCF36620OtherCASTATE LICENCE NUMBER

National Provider Directory

National Provider Directory
Tax ID family
NFSG Veterans Health System107 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Locations

1000 Ward St
Martinez, CA 94553
Phone (925) 335-4707

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750584900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WARD ST",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945531360",
            "telephone_number": "925-335-4712",
            "fax_number": "925-335-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WARD ST",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945531360",
            "telephone_number": "925-335-4712",
            "fax_number": "925-335-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTINEZ DETENTION FACILITY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TAM",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "925-335-4712"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "CA",
            "license": "LCF36620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE NUMBER",
            "identifier": "LCF36620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.