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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