Provider Demographics
NPI:1982933008
Name:US DEPT OF JUSTICE
Entity Type:Organization
Organization Name:US DEPT OF JUSTICE
Other - Org Name:DEPT OF JUSTICE BUREAU OF PRISONS FCC TUCSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-663-5000
Mailing Address - Street 1:9300 S WILMOT RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85756-9706
Mailing Address - Country:US
Mailing Address - Phone:520-663-5000
Mailing Address - Fax:520-663-5146
Practice Address - Street 1:9300 S WILMOT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85756-9706
Practice Address - Country:US
Practice Address - Phone:520-663-5000
Practice Address - Fax:520-663-5146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-19
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0356508OtherNCPDP PROVIDER IDENTIFICATION NUMBER