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RIVERSIDE SAN BERNARDINO COUNTY INDIAN HEALTH INC NPI 1902954944


NPI Information

NPI: 1902954944
Provider Name: RIVERSIDE SAN BERNARDINO COUNTY INDIAN HEALTH INC

Doing Business As: MORANGO INDIAN CLINIC PHARMACY

Classification: Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy - 332800000X
Entity Type: Organization
Address:
11555 1/2 POTRERO RD
BANNING, CA
ZIP 92220
Phone: (951) 849-4761
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RIVERSIDE SAN BERNARDINO COUNTY INDIAN HEALTH INC is an indian health service tribal urban indian health i t u pharmacy in Banning, 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. RIVERSIDE SAN BERNARDINO COUNTY INDIAN HEALTH INC NPI is 1902954944. The provider is registered as an organization entity type.
The provider Is Doing Business As Morango Indian Clinic Pharmacy.

The provider's business location address is:

11555 1/2 POTRERO RD
BANNING, CA
ZIP 92220-946
Phone: (951) 849-4761
Fax: (951) 849-0681

The provider's authorized official is Sue Yoon .
The authorized official title is Director Of Pharmacy and has the following contact phone number (909) 864-1097.

The enumeration date for this NPI number is 1/8/2007 and was last updated on 3/29/2017.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
2332800000XIndian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyPHY32790CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1FHC03854MEDICAIDCALIFORNIA
21998432OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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