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Susanville Indian Rancheria
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Susanville, California
NPI 1053484998

Susanville Indian Rancheria is a Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy based in Susanville, CA. Susanville Indian Rancheria practices in Susanville, CA. The NPI Number for Susanville Indian Rancheria is 1053484998 and holds a License No. PHE47046 (California).

The current practice location address for Susanville Indian Rancheria is 795 Joaquin St, Susanville, CA and can be reached out via phone at 530-257-8581 and via fax at 530-251-1846.

Location: 795 Joaquin St, Susanville, CA, 96130-3628
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1053484998
Provider Name
Susanville Indian Rancheria
Credential
Provider Entity Type
Organization
Address
795 Joaquin St, Susanville, CA, 96130-3628
Phone Number
530-257-8581
Fax Number
530-251-1846
Provider Enumeration Date
11/16/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PHA470460 05 CA
institution
Provider Business Practice Location Address Details
Address
795 Joaquin St
City
Susanville
State
California
Zip
96130-3628
Phone Number
530-257-8581
Fax Number
530-251-1846
person
Provider Business Mailing Address Details
Address
795 Joaquin St
City
Susanville
State
California
Zip
96130-3628
Phone Number
530-257-8581
Fax Number
530-251-1846
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Speciality
-
Taxonomy
332800000X
License No.
PHE47046 (California)
Definition
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.
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