Healthcare Provider Details

I. General information

NPI: 1508765835
Provider Name (Legal Business Name): PIT RIVER HEALTH SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2026
Last Update Date: 11/03/2026
Certification Date: 11/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36977 PARK AVE
BURNEY CA
96013-4067
US

IV. Provider business mailing address

36977 PARK AVE
BURNEY CA
96013-4067
US

V. Phone/Fax

Practice location:
  • Phone: 530-335-5090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332800000X
TaxonomyIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SOPHIA RAE VILLARRUEL
Title or Position: HUMAN RESOURCE MANAGER
Credential:
Phone: 530-335-0332