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Organization
CHAPA-DE INDIAN HEALTH PROGRAM INC
Active
Organization
CHAPA-DE INDIAN HEALTH PROGRAM INC
Active
Other names
Chapa-De Indian Health Program Pharmacy-Grass Valley
Organization subpart
No
Provider details
NPI number
Authorized official
LISA DAVIES (CFO)
(530) 887-2800
Entity
Organization
Contact information
Practice address
1350 E MAIN ST, PHARMACY DEPT, GRASS VALLEY, CA 95945-5208
(530) 477-5968
(530) 477-8738
Mailing address
1350 E MAIN ST, PHARMACY DEPT, GRASS VALLEY, CA 95945-5208
(530) 477-5968
(530) 477-8738
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
PHY49917
CA
333600000X
Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942435946
—
CA
01
—
2120323
PK
—
Enumeration date
05/19/2009
Last updated
03/01/2017
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