Organization · Type 2 NPI
Southshore Tribal Health Pharmacy
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Clearlake, CA
Practice location
14440 Olympic Drive, Suite B
Clearlake, CA 95422-9545
Fax (707) 263-5019
Mailing address
925 Bevins Ct
Lakeport, CA 95453-9754
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Primary | 332800000X | None listed |
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.
3 other providers at this address
About NPI 1376289322
Southshore Tribal Health Pharmacy's National Provider Identifier is 1376289322, issued on May 11, 2022. The primary taxonomy on file is Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (332800000X), and the practice location is in Clearlake, CA. The record was last updated on Aug 7, 2024.