OrganizationActive
Lassen Indian Health Center
NPI 1053484998 · Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Susanville, CA
Provider details
- NPI number
- 1053484998
- Entity type
- Organization
- Primary specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacySuppliers
- Parent organization
- Susanville Indian Rancheria
- Organization subpart
- Yes
- Authorized official
- Lona Marioneaux Ibanitoru, Ceo(530) 251-5173
- License
- PHE47046 (CA)
Specialties & taxonomies
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyPrimary332800000XLicense PHE47046 (CA)
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
795 Joaquin St
Susanville, CA 96130-3628
Phone: (530) 251-5173
Fax: (530) 251-1846
Street-level locationGet directions
Mailing address
795 Joaquin St
Susanville, CA 96130-3628
Other names (DBA / former)
- Other name
- Lassen Indian Health Center Pharmacy
- Doing business as
- Lassen Indian Health Center Pharmacy
Registry dates
- Enumerated
- 2006-11-16
- Last updated
- 2026-03-04
- Certified
- 2026-03-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.