Organization Name: | FEDERAL CORRECTIONAL INSTITUTION SHERIDAN |
NPI Number: | 1093176976 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JIM W. MANNING (CHIEF PHARMACIST) |
Mailing Address: | 27072 Sw Ballston Rd Sheridan |
State: | OR US |
Postal Code: | 973789620 |
Phone Number: | 5038436446 |
Fax Number: | 5038436657 |
NPI Enumeration Date: | 03/18/2016 |
NPI Last Update Date: | 03/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
Taxonomy Definition: |