Provider Demographics
NPI:1659786721
Name:INLAND BEHAVIORAL AND HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:INLAND BEHAVIORAL AND HEALTH SERVICES, INC.
Other - Org Name:IBHS PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TEMETRY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-708-8158
Mailing Address - Street 1:PO BOX 956
Mailing Address - Street 2:
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220-0007
Mailing Address - Country:US
Mailing Address - Phone:909-708-8158
Mailing Address - Fax:909-888-3627
Practice Address - Street 1:1070 E RAMSEY ST STE C
Practice Address - Street 2:
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-5924
Practice Address - Country:US
Practice Address - Phone:951-846-2560
Practice Address - Fax:951-849-2310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-26
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY516843336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy