| Organization Name: | JAIL HEALTH SERVICES PHARMACY |
| NPI Number: | 1104033661 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELAINA MAY CHIN (PHARMACIST IN CHARGE) |
| Mailing Address: | 1 Moreland Dr Cj5 Pharmacy San Bruno |
| State: | CA US |
| Postal Code: | 940661670 |
| Phone Number: | 6502667577 |
| Fax Number: | 6502661740 |
| NPI Enumeration Date: | 05/16/2007 |
| NPI Last Update Date: | 07/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2400X |
| License Number: | LCF40885 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Prison Health |
| Taxonomy Definition: | |