Organization
LASSEN INDIAN HEALTH CENTER
Active
Parent organization
SUSANVILLE INDIAN RANCHERIA
Other names
Lassen Indian Health Center Pharmacy, Lassen Indian Health Center Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUSANVILLE INDIAN RANCHERIA
Authorized official
LONA MARIE MARIONEAUX IBANITORU (CEO)
(530) 251-5173
Entity
Organization
Contact information
Practice address
795 JOAQUIN ST, SUSANVILLE, CA 96130-3628
(530) 251-5173
(530) 251-1846
Mailing address
795 JOAQUIN ST, SUSANVILLE, CA 96130-3628
(530) 251-5173
(530) 251-1846
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
PHE47046
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA470460
—
CA
Enumeration date
11/16/2006
Last updated
03/04/2026
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