| Organization Name: | FEDERAL BUREAU OF PRISONS |
| NPI Number: | 1518225127 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEFFREY G. TRIMBATH (HEALTH SERVICES ADMINISTRATOR/PA-C) |
| Mailing Address: | 772 Saint Joseph St Loretto |
| State: | PA US |
| Postal Code: | 159407006 |
| Phone Number: | 8144711579 |
| Fax Number: | 8144711596 |
| NPI Enumeration Date: | 05/02/2012 |
| NPI Last Update Date: | 05/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP0904X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Public Health, Federal |
| Taxonomy Definition: | |