Chinook Healthcare in

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

1680000058 Issued in CO

Legal business name

CHINOOK HEALTHCARE IN

Doing business as

Chinook LTC

Practice address

275 Waneka Pkwy Ste 10
Lafayette, CO 80026-8857

Phone

(720) 458-4887

Fax

(720) 890-6144

NPI assigned

May 8, 2018

Last updated

May 8, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tyson Hodge

Title

President

Phone

(720) 458-4887

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Chinook LTC Doing business as

Tax ID family

Chinook Healthcare in2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Chinook Healthcare in

  • Dialysis Equipment & Supplies (DME)
  • Louisville, CO
  • NPI 1952686164
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525737600000",
    "number": "1134618879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 WANEKA PKWY",
            "address_2": "SUITE 10",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800268873",
            "telephone_number": "720-458-4887",
            "fax_number": "720-890-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 WANEKA PKWY STE 10",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800268857",
            "telephone_number": "720-458-4887",
            "fax_number": "720-890-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHINOOK HEALTHCARE IN",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-08",
        "last_updated": "2018-05-08",
        "status": "A",
        "authorized_official_last_name": "HODGE",
        "authorized_official_first_name": "TYSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "720-458-4887"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CO",
            "license": "1680000058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2177389",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54930022",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chinook LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lan Chen, MD
• Patti Lee Chenis, L.P.C.
• Stephen Cheung, DO
• Hyosang Abraham Chiang, M.D.
• Peter P Chiang, M.D.
• Chinook Healthcare Inc (Chinook Healthcare Pharmacy)
• Jennie Cho, O.D.
• Kara Jihea Choi, MD
• Choices in Health, PC
• Julio Tian-Fa Chong, MD

• Long Term Care Pharmacy in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Long Term Care Pharmacy in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.