# CHINOOK HEALTHCARE IN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952686164
- **Authorized official:** MR. TYSON C HODGE (PRESIDENT)
- **Authorized official phone:** (720) 458-4887

## Contact information

- **Practice address:** 325 W S BOULDER RD, SUITE 5, LOUISVILLE, CO 80027-1130
- **Practice address phone:** (720) 458-4887
- **Practice address fax:** (720) 890-6144
- **Mailing address:** 325 W S BOULDER RD, SUITE 5, LOUISVILLE, CO 80027-1130
- **Mailing address phone:** (720) 458-4887
- **Mailing address fax:** (720) 890-6144

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | — | NULL | — |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | — |
| 332BD1200X | Dialysis Equipment & Supplies (DME) | — | NULL | Yes |

## Other

- **Enumeration date:** 10/19/2011
- **Last updated:** 10/19/2011