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CENTINELLA STATE PRISON
NPI 1679108476
Pharmacy in Imperial, CA

Active since March 12, 2020CLIA 05D1015155 · Waiver
2302 BROWN ROAD, IMPERIAL, CA 92251(760) 337-7900(760) 482-3006 Get Directions Write a Review

NPPES record last updated: December 4, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 4, 2024, Mar 12, 2020 (2 updates tracked since 2020).

About Centinella State Prison NPPES

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

CENTINELLA STATE PRISON (NPI 1679108476) is a healthcare organization registered as a pharmacy in Imperial, California and active in the NPI registry since March 2020. The organization holds a CLIA Waiver certificate valid through July 23, 2027 and lists Pierre Caesare Saucier James, Staff Services Manager I, as its authorized official.

NPPES Registry Identity

NPI1679108476
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameCORRECTIONS AND REHABILITATION-HEADQUARTERS
Location Address2302 BROWN ROADImperial, CA 92251
Mailing AddressP.o. Box 731Imperial, CA 92251-0731 · (760) 337-7900 · Fax (760) 482-3006
Phone(760) 337-7900
Fax(760) 482-3006
Organization SubpartYesParent: Corrections And Rehabilitation
Authorized OfficialPierre Caesare Saucier JamesStaff Services Manager I · (510) 780-6997
Enumeration DateMarch 12, 2020
Last NPPES UpdateDecember 4, 20242 updates tracked since enumeration
NPPES CertifiedDecember 4, 2024
✔ NPI 1679108476 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.
2302 BROWN ROAD, Imperial, CA 92251
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Other Names 1

Doing Business AsCentinella State Prison

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 05D1015155

Centinela State Prison Correctional · Imperial, CA
Active · expires Jul 23, 2027
CLIA Number05D1015155
Laboratory TypePrison
Certificate Effective DateJuly 24, 2025
Certificate Expiration DateJuly 23, 2027
Laboratory DirectorAjmel Sangha
Laboratory Phone(760) 337-7900
Laboratory LocationCentinela State Prison CorrectionalCentral Health 2302 Brown Rd, Imperial, CA 92251
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

DR. JOHN PRICE GOULDY M.D.
Psychiatry & Neurology (Psychiatry)
2302 BROWN ROAD
IMPERIAL, CA 92251
Imperial County (760) 337-7900
DR. NELSON B. MUSGRAVE D.D.S.
Dentist
2302 BROWN ROAD, CENTINELA STATE PRISON
IMPERIAL, CA 92251
Imperial County (760) 337-7900
MARTIN ANTHONY WHEELER PHARMD
Pharmacist
2302 BROWN ROAD
IMPERIAL, CA 92251
Imperial County (760) 337-7900
VANESSA MARIE CERVANTES
Social Worker (Clinical)
2302 BROWN ROAD
IMPERIAL, CA 92251
Imperial County (760) 337-7900
DR. ROBERT PAUL KUENZI D.D.S.
Dentist (General Practice)
2302 BROWN ROAD
IMPERIAL, CA 92251
Imperial County (760) 337-7900
DR. LLOYD N SMITH D.D.S.
Dentist (General Practice)
2302 BROWN ROAD
IMPERIAL, CA 92251
Imperial County (760) 337-7900
NELSON B MUSGRAVE DDS INC
Dentist (General Practice)
2302 BROWN ROAD, DENTAL DEPT
IMPERIAL, CA 92251
Imperial County (760) 733-7900

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 1679108476. It was assigned to this organization in the NPPES registry on March 12, 2020. The provider is doing business as Centinella State Prison.

Where is Corrections And Rehabilitation-Headquarters located?

Corrections And Rehabilitation-Headquarters is located at 2302 Brown Road, Imperial, CA 92251. The listed phone number is (760) 337-7900.

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 05D1015155) is associated with this NPI, valid through July 23, 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.