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Organization
CHIEF SUPER MARKET INC
Active
Organization
CHIEF SUPER MARKET INC
Active
Other names
CHIEF PHARMACY AND WELLNESS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA STAFFORD (CORPORATE SECRETARY)
(419) 782-0950
Entity
Organization
Contact information
Practice address
705 DEATRICK ST, DEFIANCE, OH 43512-2785
(419) 784-0088
(419) 784-2273
Mailing address
1340 W HIGH ST, STE E, DEFIANCE, OH 43512-5302
(419) 784-0088
(419) 784-2273
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
021695800
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2737480
—
OH
01
—
3668641
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/03/2006
Last updated
04/25/2012
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