Chief Super Market Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

021695800 Issued in OH

Legal business name

CHIEF SUPER MARKET INC

Doing business as

Chief Pharmacy and Wellness Center

Practice address

705 Deatrick St
Defiance, OH 43512-2785

Phone

(419) 784-0088

Fax

(419) 784-2273

NPI assigned

Oct 3, 2006

Last updated

Apr 25, 2012By 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

Theresa Stafford

Title

Corporate Secretary

Phone

(419) 782-0950

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• CHIEF PHARMACY AND WELLNESS CENTER Doing business as

Locations

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1851485148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 W HIGH ST",
            "address_2": "STE E",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435125302",
            "telephone_number": "419-784-0088",
            "fax_number": "419-784-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 DEATRICK ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122785",
            "telephone_number": "419-784-0088",
            "fax_number": "419-784-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIEF SUPER MARKET INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "STAFFORD",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "419-782-0950"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "021695800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3668641",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2737480",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHIEF PHARMACY AND WELLNESS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joshua Glenn Cass
• Teya Castillo
• Brittany Casto, LPN
• Robert Cerniglia, CCDCI
• Tanya Chappuies, LMT
• City of Defiance
• Sarah J Claridge, LSW
• Rachel Clark, PT, DPT
• Megan Claybaugh, CDCA
• Kari Clemens, COTA

• Community/Retail Pharmacy in Defiance, OH
• Providers in Defiance, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.