NPIMap

Organization Active NPI

Corrections and Rehabilitation-Headquarters

Doing business as Folsom State Prison

  • Pharmacy
  • Represa, CA
National Provider Identifier
1821621764
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
CORRECTIONS AND REHABILITATION-HEADQUARTERS
Doing business as
Folsom State Prison
Practice address
300 Prison Road
Represa, CA 95671-4071
Phone
(916) 985-2561
Fax
(916) 608-3112
NPI assigned
Feb 19, 2020
Last updated
Dec 4, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
CORRECTIONS & REHABILITATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Authorized official

Name
Pierre Caesare Saucier James
Title
Staff Services Manager I
Phone
(510) 780-6997

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

300 Prison Road
Represa, CA 95671-4071

Mailing address

300 Prison Road
Represa, CA 95671-4071
Phone (916) 985-2561

Other names 1

  • Folsom State Prison Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1083620Folsom State Prison300 Prison Road (FSP-Lab-CHS), Represa, CA 95671Certificate of waiverJul 8, 2028

National Provider Directory

National Provider Directory
Tax ID family
Corrections and Rehabilitation-Headquarters42 organizations share this tax ID, including this one
Part of
Corrections and Rehabilitation-Headquarters

Other organizations with this tax ID 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

Locations

300 Prison Rd
Represa, CA 95671
Phone (916) 985-2561

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1821621764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PRISON ROAD",
            "city": "REPRESA",
            "state": "CA",
            "postal_code": "956714071",
            "telephone_number": "916-985-2561",
            "fax_number": "916-608-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PRISON ROAD",
            "city": "REPRESA",
            "state": "CA",
            "postal_code": "956714071",
            "telephone_number": "916-985-2561",
            "fax_number": "916-608-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORRECTIONS AND REHABILITATION-HEADQUARTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORRECTIONS & REHABILITATION",
        "enumeration_date": "2020-02-19",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "PIERRE",
        "authorized_official_middle_name": "CAESARE SAUCIER",
        "authorized_official_title_or_position": "STAFF SERVICES MANAGER I",
        "authorized_official_telephone_number": "510-780-6997"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Folsom State Prison",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Folsom State Prison",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Represa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.