SUSANVILLE INDIAN RANCHERIA NPI 1053484998

NPI Information

SUSANVILLE INDIAN RANCHERIA is an indian health service tribal urban indian health i t u pharmacy in Susanville, CA. The provider is an Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603. SUSANVILLE INDIAN RANCHERIA NPI is 1053484998. The provider is registered as an organization entity type.
The provider Other Name Is Lassen Indian Health Center Pharmacy.

The provider's business location address is:

795 JOAQUIN ST
SUSANVILLE, CA
ZIP 96130-628
Phone: (530) 257-8581
Fax: (530) 251-1846

The provider's authorized official is Stacy Dixon .
The authorized official title is Tribal Chairman and has the following contact phone number (530) 257-6264.

The enumeration date for this NPI number is 11/16/2006 and was last updated on 7/16/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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