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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
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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