Southshore Tribal Health Pharmacy
NPI #1376289322 in Clearlake, California
Provider Information
- NPI Number
- 1376289322
- Entity Type
- Organization
- Organization Name
- Southshore Tribal Health Pharmacy
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- LAKE COUNTY TRIBAL HEALTH CONSORTIUM INC.
- Primary Specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Enumeration Date
- May 11, 2022
- Last Updated
- Aug 7, 2024
Practice Location
- Address
- 14440 OLYMPIC DRIVE
- Address 2
- SUITE B
- City
- Clearlake
- State
- California
- ZIP Code
- 95422-9545
- Phone
- (707) 263-8382
Authorized Official
- Name
- MR. THOMAS BURNETT
- Title
- IT SPECIALIST
- Phone
- (707) 263-8382
Specialties & Taxonomy Codes
| Specialty |
|---|
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
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