Shingle Springs Health And Wellness Center

LBN: Shingle Springs Rancheria
Shingle Springs Health And Wellness Center is an health care organization with primary practice located at 5168 Honpie Rd 5Th Floor, Placerville CA 95667-8682. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy, Suppliers / Pharmacy, Suppliers / Clinic Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy is the primary health care specialty. Shingle Springs Rancheria can be contacted via phone (530) 387-8215, or through Bodtker, John via phone (530) 387-8005.

Contact Information

Primary practice address
5168 Honpie Rd 5Th Floor Placerville CA 95667-8682
Phone: (530) 387-8215
Fax: (530) 676-4416
Website:
Map and Directions
Authorized official contact:
Name: Bodtker, John PHARMD
Phone: (530) 387-8005

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X PHY55274 California
Suppliers / Pharmacy 333600000X
Suppliers / Clinic Pharmacy 3336C0002X
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1710423793
LBN Legal business name Shingle Springs Rancheria
DBA Doing business as Shingle Springs Health And Wellness Center
Authorized official Bodtker, John PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Jan 13th, 2017
Last updated Jul 19th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710423793 NPPES
California MEDICAID 1710423793
California Other 2167303

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