San Manuel Indian Health Clinic Pharmacy

LBN: Riverside-San Bernardino County Indian Health Inc
San Manuel Indian Health Clinic Pharmacy is an health care organization with primary practice located at 11980 Mount Vernon Ave , Grand Terrace CA 92313-5172. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy, Suppliers / Pharmacy. Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy is the primary health care specialty. Riverside-San Bernardino County Indian Health Inc can be contacted via phone (909) 864-1097, or through Dhouni, Jeevan via phone (909) 864-1097.

Contact Information

Primary practice address
11980 Mount Vernon Ave Grand Terrace CA 92313-5172
Phone: (909) 864-1097
Fax: (909) 503-1218
Website:
Map and Directions
Authorized official contact:
Name: Dhouni, Jeevan BS
Phone: (909) 864-1097

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X PHY52145 California
Suppliers / Pharmacy 333600000X

Profile Details

NPI number 1174724637
LBN Legal business name Riverside-San Bernardino County Indian Health Inc
DBA Doing business as San Manuel Indian Health Clinic Pharmacy
Authorized official Dhouni, Jeevan BS
Entity Organization
Organization subpart 1 No
Enumeration date May 30th, 2007
Last updated Mar 9th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174724637 NPPES
Other 1993983 PK

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