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General NPI Number Information
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NPI Number | 1568461267
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Entity Type | Organization
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Legal Business Name | SONOMA COUNTY INDIAN HEALTH PROJECT, INC
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 08/09/2023
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Provider Practice Location Address
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Address Line | 144 STONY POINT RD
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City | SANTA ROSA
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State | CA
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Zip | 95401-4122
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Country | US
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Telephone | 707-521-4585
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Fax | 707-521-4599
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Provider Business Mailing Address
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Address Line | 144 STONY POINT RD
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City | SANTA ROSA
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State | CA
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Zip | 95401-4122
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Country | US
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Telephone | 707-521-4585
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Fax | 707-521-4599
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Authorized Official
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Title or Position | INTERIM CEO
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Name | BETTY ARTERBERRY
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Credential |
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Telephone | 707-521-4660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY45307
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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