IHC SANTA YSABEL PHARMACY (NPI# 1407252588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407252588 |
| Entity Type | Organization |
| Organization Name | IHC SANTA YSABEL PHARMACY |
| Other Organization Name | IHC SANTA YSABEL PHARMACY |
| Practice Address |
110 1/2 School House Canyon Road Santa Ysabel CA 92070 |
| Mailing Address |
Po Box 10 Santa Ysabel CA 92070-0010 |
| Practice Telephone | 7602335587 |
| Practice Fax Number | 7607653769 |
| Mailing Telephone | 7602335587 |
| Mailing Fax Number | 7607653769 |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2014-11-17 |
| Authorized Official Name | ROBERT SCHOSTAG (PHARMACY DIRECTOR) |
| Authorized Official Telephone | 7607491410 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | PHY46552 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2148638 | 01 |
| Other Name | Type Code |
|---|---|
| IHC Santa Ysabel Pharmacy | Doing Business As Name - Organization |
| Street Address |
110 1/2 SCHOOL HOUSE CANYON ROAD |
| City | SANTA YSABEL |
| State | CA |
| Zip Code | 92070 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043396005 | Indian Health Council, Inc. | Clinic/Center | 110 1/2 School House Canyon Road, Santa Ysabel, CA 92070 | 2006-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073792032 | Santa Ysabel Social Service | Case Management | 101 Schoolhouse Canyon Road, Santa Ysabel, CA 92070 | 2007-10-26 |
| 1538292115 | Debra Joann Evans Gernandt | Marriage & Family Therapist | 30240 Highway 78, Santa Ysabel, CA 92070 | 2007-03-13 |
| 1821101924 | Anna Lee Benson | Psychologist | 30240 Hwy 78, Santa Ysabel, CA 92070 | 2006-08-16 |
| 1750449625 | Karen Hawthorne | Psychologist | 30240 Hwy 78, Santa Ysabel, CA 92070 | 2006-12-04 |
| 1033443643 | Maher Alghabra | Pharmacist | 170 Town Ctr Pky, San Diego, CA 92070-1661 | 2009-09-29 |
| 1639626641 | Sharon Ann Beal Armendariz | Social Worker | 30240 Hwy 78, Santa Ysabel, CA 92070-9207 | 2016-09-07 |
| Taxonomy Code | 332800000X |
| Grouping | Suppliers |
| Classification | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| 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. |
| Notes: Source: The Medicare Prescription Drug, Improvement and Modernization Act of 2003 [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598108847 | Hometown Ltc Pharmacy Inc | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1450 W Mccoy Ln Ste B, Santa Maria, CA 93455-1059 | 2013-04-16 |
| 1144873811 | Hometown Ltc Pharmacy Inc | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1009 E Grand Ave, Arroyo Grande, CA 93420-2504 | 2019-07-22 |
| 1053484998 | Susanville Indian Rancheria | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 795 Joaquin St, Susanville, CA 96130-3628 | 2006-11-16 |
| 1982782256 | United Indian Health Services Inc | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1600 Weeot Way, Arcata, CA 95521-4734 | 2006-11-02 |
| 1699881540 | Tuolumne Me-wuk Indian Health Center Incorporated | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 18880 Cherry Valley Blvd, Tuolumne, CA 95379-9506 | 2006-08-22 |
| City | SANTA YSABEL |
| Zip Code | 92070 |
Please comment or provide details below to improve the information on IHC SANTA YSABEL PHARMACY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.