| NPI | 1528402336 |
|---|---|
| Doing Business As | LAKE COUNTY TRIBAL HEALTH PHARMACY |
| Entity Type | Organization |
| Authorized Contact | ERNESTO PADILLA Executive Director 707-263-8382 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA 51235) |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: CA 51235) |
| 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (Licence: CA 51235) | |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2013-04-25 |