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General NPI Number Information
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NPI Number | 1942435946
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Entity Type | Organization
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Legal Business Name | CHAPA-DE INDIAN HEALTH PROGRAM INC
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 03/01/2017
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Provider Practice Location Address
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Address Line | 1350 E MAIN ST PHARMACY DEPT
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City | GRASS VALLEY
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State | CA
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Zip | 95945-5208
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Country | US
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Telephone | 530-477-5968
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Fax | 530-477-8738
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Provider Business Mailing Address
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Address Line | 1350 E MAIN ST PHARMACY DEPT
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City | GRASS VALLEY
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State | CA
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Zip | 95945-5208
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Country | US
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Telephone | 530-477-5968
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Fax | 530-477-8738
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Authorized Official
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Title or Position | CFO
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Name | LISA DAVIES
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Credential |
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Telephone | 530-887-2800
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332800000X
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Taxonomy Name | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
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License Number | PHY49917
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License Number State | CA
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