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General NPI Number Information
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NPI Number | 1316908635
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Entity Type | Organization
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Legal Business Name | STATE OF CALIFORNIA PRISON INDUSTRY AUTHORITY
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 560 E NATOMA ST
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City | FOLSOM
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State | CA
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Zip | 95630-2233
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Country | US
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Telephone | 916-358-1738
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Fax | 916-358-2792
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Provider Business Mailing Address
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Address Line | PO BOX 127
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City | NAPA
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State | CA
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Zip | 94559-0127
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Country | US
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Telephone | 707-255-3300
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Fax | 707-255-3527
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Authorized Official
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Title or Position | PRISON INDUSTRIES MANAGER
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Name | EARL C. SHATZER
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Credential |
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Telephone | 916-358-1738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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