Provider Demographics
NPI:1053674051
Name:CHAKRI LLC
Entity Type:Organization
Organization Name:CHAKRI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFINY
Authorized Official - Middle Name:
Authorized Official - Last Name:KASZUBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-397-5466
Mailing Address - Street 1:11711 ARBOR ST
Mailing Address - Street 2:SUITE 240
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2979
Mailing Address - Country:US
Mailing Address - Phone:402-393-9459
Mailing Address - Fax:402-397-1977
Practice Address - Street 1:11766 WHITMORE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68142-1639
Practice Address - Country:US
Practice Address - Phone:712-328-5490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty