Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
PECHANGA INDIAN HEALTH CLINIC PHARMACY
Active
Organization
PECHANGA INDIAN HEALTH CLINIC PHARMACY
Active
Other names
Pechanga Indian Health Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM THOMSEN (CEO)
(909) 864-1097
Entity
Organization
Contact information
Practice address
47001 PALA RD, TEMECULA, CA 92592-2925
(951) 676-6810
(951) 676-6421
Mailing address
12784 PECHANGA RD, TEMECULA, CA 92592
(951) 676-6810
(951) 676-6421
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
50823
CA
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5646178
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/31/2012
Last updated
10/07/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up