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CALIFORNIA STATE PRISON PHARMACY
NPI 1124648712
Pharmacy in Vacaville, CA

Active since April 23, 2020CLIA 05D0884537 · Waiver
2100 PEABODY ROAD, VACAVILLE, CA 95687(707) 451-0182(707) 454-3400 Get Directions Write a Review

NPPES record last updated: December 4, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 4, 2024, Apr 23, 2020 (2 updates tracked since 2020).

About California State Prison Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CALIFORNIA STATE PRISON PHARMACY (NPI 1124648712) is a healthcare organization registered as a pharmacy in Vacaville, California and active in the NPI registry since April 2020. The organization holds a CLIA Waiver certificate valid through May 24, 2027 and lists Pierre Caesare Saucier James, Staff Services Manager I, as its authorized official.

NPPES Registry Identity

NPI1124648712
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameCORRECTIONS AND REHABILITATION-HEADQUARTERS
Location Address2100 PEABODY ROADVacaville, CA 95687
Mailing AddressP.o. Box 4000Vacaville, CA 95696-4000 · (707) 451-0182 · Fax (707) 454-3400
Phone(707) 451-0182
Fax(707) 454-3400
Organization SubpartYesParent: Corrections And Rehabilitation
Authorized OfficialPierre Caesare Saucier JamesStaff Services Manager I · (510) 780-6997
Enumeration DateApril 23, 2020
Last NPPES UpdateDecember 4, 20242 updates tracked since enumeration
NPPES CertifiedDecember 4, 2024
✔ NPI 1124648712 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
2100 PEABODY ROAD, Vacaville, CA 95687
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Other Names 1

Doing Business AsCalifornia State Prison Pharmacy

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0884537

California State Prison Solano · Vacaville, CA
Active · expires May 24, 2027
CLIA Number05D0884537
Laboratory TypePrison
Certificate Effective DateMay 25, 2025
Certificate Expiration DateMay 24, 2027
Laboratory DirectorMartin C. Kuersten
Laboratory Phone(707) 451-0182
Laboratory LocationCalifornia State Prison Solano2100 Peabody Road Attn Laboratory Supervisor, Vacaville, CA 95687
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STATE OF CALIFORNIA PRISON INDUSTRY AUTHORITY
Eyewear Supplier
2100 PEABODY ROAD
VACAVILLE, CA 95687
Solano County (707) 451-0182
ALFREDO QUICHO NORIEGA M.D.
Surgery
2100 PEABODY ROAD
VACAVILLE, CA 95687
Solano County (707) 451-0182
DR. ALVARO CRUZ TRAQUINA M.D.
Surgery
2100 PEABODY ROAD, MEDICAL MODULAR
VACAVILLE, CA 95687
Solano County (707) 454-3261
DR. SEGUNDINA AGUSTIN YANCHA MD
Psychiatry & Neurology (Psychiatry)
2100 PEABODY ROAD, CSP SOLANO
VACAVILLE, CA 95687
Solano County (707) 451-0182

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Corrections And Rehabilitation-Headquarters's NPI number?

The NPI number for Corrections And Rehabilitation-Headquarters is 1124648712. It was assigned to this organization in the NPPES registry on April 23, 2020. The provider is doing business as California State Prison Pharmacy.

Where is Corrections And Rehabilitation-Headquarters located?

Corrections And Rehabilitation-Headquarters is located at 2100 Peabody Road, Vacaville, CA 95687. The listed phone number is (707) 451-0182.

What is Corrections And Rehabilitation-Headquarters's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Corrections And Rehabilitation-Headquarters hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0884537) is associated with this NPI, valid through May 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Corrections And Rehabilitation-Headquarters was last updated on December 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.