NPIMap

Organization Active NPI

Southern Indian Health Council

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Alpine, CA
National Provider Identifier
1235280223
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
License
PHE35491 Issued in CA
Legal business name
SOUTHERN INDIAN HEALTH COUNCIL
Doing business as
SOUTHERN INDIAN HEALTH COUNCIL
Practice address
4058 Willows Rd
Alpine, CA 91901-1668
Phone
(619) 445-1188
Fax
(619) 445-2892
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dean Garcia, PHARMD
Title
Pic
Phone
(619) 445-1188

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X PHE35491 CA Primary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

4058 Willows Rd
Alpine, CA 91901-1668

Mailing address

4058 Willows Rd
Alpine, CA 91901-1668
Phone (619) 445-1188

Other identifiers 2

IdentifierTypeStateIssuer
1997735OtherPK
PHE35491MedicaidCA

Other names 1

  • SOUTHERN INDIAN HEALTH COUNCIL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southern Indian Health5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4058 Willows Rd
Alpine, CA 91901
Phone (619) 445-1188

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1235280223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4058 WILLOWS RD",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919011668",
            "telephone_number": "619-445-1188",
            "fax_number": "619-445-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4058 WILLOWS RD",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919011668",
            "telephone_number": "619-445-1188",
            "fax_number": "619-445-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN INDIAN HEALTH COUNCIL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "619-445-1188",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "CA",
            "license": "PHE35491",
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1997735",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHE35491",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHERN INDIAN HEALTH COUNCIL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alpine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.