Susanville Indian Rancheria
NPI #1053484998 in Susanville, California
Provider Information
- NPI Number
- 1053484998
- Entity Type
- Organization
- Organization Name
- Susanville Indian Rancheria
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- SUSANVILLE INDIAN RANCHERIA
- Primary Specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Enumeration Date
- Nov 16, 2006
- Last Updated
- Jul 16, 2008
Practice Location
- Address
- 795 JOAQUIN ST
- City
- Susanville
- State
- California
- ZIP Code
- 96130-3628
- Phone
- (530) 257-8581
Authorized Official
- Name
- MR. STACY DIXON
- Title
- TRIBAL CHAIRMAN
- Phone
- (530) 257-6264
Specialties & Taxonomy Codes
| Specialty |
|---|
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
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