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Organization
INDIAN HEALTH COUNCIL PHARMACY
Active
Organization
INDIAN HEALTH COUNCIL PHARMACY
Active
Other names
INDIAN HEALTH COUNCIL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SCHOSTAG RPH (PHARMACY DIRECTOR)
(760) 749-1410
Entity
Organization
Contact information
Practice address
50100 GOLSH RD, VALLEY CENTER, CA 92082
(760) 749-1410
(760) 749-0225
Mailing address
PO BOX 406, PAUMA VALLEY, CA 92061-0406
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
PHE30519
CA
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1997745
PK
—
05
—
PHA305190
—
CA
Enumeration date
06/11/2006
Last updated
11/09/2015
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