Provider Demographics
NPI:1134330764
Name:LUNDIN, CHAD EDWARD-CARL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:EDWARD-CARL
Last Name:LUNDIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:786 ELM ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-5164
Mailing Address - Country:US
Mailing Address - Phone:303-388-0578
Mailing Address - Fax:
Practice Address - Street 1:3905 E 104TH AVE
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-4439
Practice Address - Country:US
Practice Address - Phone:303-255-7170
Practice Address - Fax:303-255-4642
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17473183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist