NPIMap

Organization Active NPI

Southern Indian Health Council

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Campo, CA
National Provider Identifier
1417026758
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
PHE43448 Issued in CA
Legal business name
SOUTHERN INDIAN HEALTH COUNCIL
Doing business as
Southern Indian Health Council
Practice address
36350 Church Rd
Campo, CA 91906-2715
Phone
(619) 478-2225
Fax
(619) 478-2323
NPI assigned
Nov 8, 2006
Last updated
Nov 12, 2024By the provider in NPPES
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, RPH
Title
Pic
Phone
(619) 445-1188

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X PHE43448 CA Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

36350 Church Rd
Campo, CA 91906-2715

Mailing address

36350 Church Rd
Campo, CA 91906-2715
Phone (619) 478-2225

Other identifiers 2

IdentifierTypeStateIssuer
2113505OtherPK
PHA434480MedicaidCA

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1417026758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36350 CHURCH RD",
            "city": "CAMPO",
            "state": "CA",
            "postal_code": "919062715",
            "telephone_number": "619-478-2225",
            "fax_number": "619-478-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36350 CHURCH RD",
            "city": "CAMPO",
            "state": "CA",
            "postal_code": "919062715",
            "telephone_number": "619-478-2225",
            "fax_number": "619-478-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN INDIAN HEALTH COUNCIL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "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": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "CA",
            "license": "PHE43448",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2113505",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA434480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHERN INDIAN HEALTH COUNCIL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Campo, 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.