Lassen Indian Health Center Pharmacy

LBN: Susanville Indian Rancheria
Lassen Indian Health Center Pharmacy is an health care organization with primary practice located at 795 Joaquin St , Susanville CA 96130-3628. The organization recently has only one registered license in Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy, which is considered as the primary health care specialty. Susanville Indian Rancheria can be contacted via phone (530) 257-8581, or through Dixon, Stacy via phone (530) 257-6264.

Contact Information

Primary practice address
795 Joaquin St Susanville CA 96130-3628
Phone: (530) 257-8581
Fax: (530) 251-1846
Website:
Map and Directions
Authorized official contact:
Name: Dixon, Stacy
Phone: (530) 257-6264

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X PHE47046 California

Profile Details

NPI number 1053484998
LBN Legal business name Susanville Indian Rancheria
DBA Doing business as Lassen Indian Health Center Pharmacy
Authorized official Dixon, Stacy
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 16th, 2006
Last updated Jul 16th, 2008 - about 17 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1053484998 NPPES
California MEDICAID PHA470460

Popular Providers