NPIMap

Organization Active NPI

Ihc Santa Ysabel Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Santa Ysabel, CA
National Provider Identifier
1407252588
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
License
PHY46552 Issued in CA
Legal business name
IHC SANTA YSABEL PHARMACY
Doing business as
IHC Santa Ysabel Pharmacy
Practice address
110 1/2 School House Canyon Road
Santa Ysabel, CA 92070
Phone
(760) 233-5587
Fax
(760) 765-3769
NPI assigned
Nov 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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

Authorized official

Name
Robert Schostag
Title
Pharmacy Director
Phone
(760) 749-1410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X PHY46552 CA Primary

Addresses

Primary practice location

110 1/2 School House Canyon Road
Santa Ysabel, CA 92070

Mailing address

PO Box 10
Santa Ysabel, CA 92070-0010
Phone (760) 233-5587

Other identifiers 1

IdentifierTypeStateIssuer
2148638OtherPK

Other names 1

  • IHC Santa Ysabel Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Indian Health Council Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

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": "1416182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416182400000",
    "number": "1407252588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "SANTA YSABEL",
            "state": "CA",
            "postal_code": "920700010",
            "telephone_number": "760-233-5587",
            "fax_number": "760-765-3769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 1/2 SCHOOL HOUSE CANYON ROAD",
            "city": "SANTA YSABEL",
            "state": "CA",
            "postal_code": "92070",
            "telephone_number": "760-233-5587",
            "fax_number": "760-765-3769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC SANTA YSABEL PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-17",
        "last_updated": "2014-11-17",
        "status": "A",
        "authorized_official_last_name": "SCHOSTAG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "760-749-1410"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "CA",
            "license": "PHY46552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2148638",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IHC Santa Ysabel Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Ysabel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; 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.