MULE CREEK STATE PRISON PHARMACY
NPI 1700412368
Pharmacy in Ione, CA
NPI Status: Active since March 16, 2020
Contact Information
4001 HWY 104
IONE, CA
ZIP 95640
Phone: (209) 274-4911
Fax: (209) 274-6039
- Organization
- Pharmacy
- CLIA Number: 05D0890381
- CLIA Cert. Type: Prison
- CLIA Exp. Date: 08-16-2026
About MULE CREEK STATE PRISON PHARMACY
This page provides the complete NPI Profile along with additional information for Mule Creek State Prison Pharmacy, a provider established in Ione, California operating as a Pharmacy. The healthcare provider is registered in the NPI registry with number 1700412368 assigned on March 2020. The practitioner's primary taxonomy code is 333600000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Mule Creek State Prison Pharmacy. The authorized official of this NPI record is Pierre Caesare Saucier James (Staff Services Manager I)
- NPI
- 1700412368
- Provider Legal Name
- CORRECTIONS AND REHABILITATION-HEADQUARTERS
- Other Organization Name
- MULE CREEK STATE PRISON PHARMACY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 4001 HWY 104 IONE, CA 95640
- Location Phone
- (209) 274-4911
- Location Fax
- (209) 274-6039
- Mailing Address
- PO BOX 409099 IONE, CA 95640
- Mailing Phone
- (209) 274-4911
- Mailing Fax
- (209) 274-6039
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 03-16-2020
- Last Update Date
- 12-04-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy
- Taxonomy Code
- 333600000X
- Type
- Suppliers
- Taxonomy Description
- 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.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0890381
- Facility Type
- Prison
- Certificate Effective Date
- August 17, 2024
- Certificate Expiration Date
- August 16, 2026
- Laboratory Director
- DR. WESLEY VAUGHN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Mule Creek State Prison Pharmacy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1700412368, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 52 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 11 providers are registered at the same or a nearby location.
IONE, CA 95640
IONE, CA 95640
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1700412368, enumerated as an "organization" on March 16, 2020.
The provider is located at 4001 HWY 104 IONE, CA 95640 and the phone number is (209) 274-4911.
Pharmacy with taxonomy code 333600000X.
