DUANE WATERS CORRECTIONAL PHARMACY NPI 1770031957

NPI Information

NPI: 1770031957
Provider Name: DUANE WATERS CORRECTIONAL PHARMACY

Other Name: PHARMACORR

Classification: Clinic/Center - 261QP2400X
Entity Type: Organization

Specialization: Prison Health

CLIA Number: 23D2057918

Address:
3857 COOPER ST
JACKSON, MI
ZIP 49201
Phone: (517) 780-5479
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DUANE WATERS CORRECTIONAL PHARMACY is a prison health clinic center in Jackson, MI. DUANE WATERS CORRECTIONAL PHARMACY NPI is 1770031957. The provider is registered as an organization entity type.
The provider Other Name Is Pharmacorr.

The provider's business location address is:

3857 COOPER ST
JACKSON, MI
ZIP 49201-547
Phone: (517) 780-5479

The provider's authorized official is Timothy Courser .
The authorized official title is Director and has the following contact phone number (517) 780-5474.

The CLIA number assigned to this NPI record is 23D2057918 - prison with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/15/2016 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2400X	Clinic/Center	Prison Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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