Provider Demographics
NPI:1740563766
Name:CHUPKA, JEFFREY ALLEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALLEN
Last Name:CHUPKA
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 1:6011 RANGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-7301
Mailing Address - Country:US
Mailing Address - Phone:719-593-7119
Mailing Address - Fax:719-593-7131
Practice Address - Street 1:6011 RANGEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-7301
Practice Address - Country:US
Practice Address - Phone:719-593-7119
Practice Address - Fax:719-593-7131
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17304183500000X
FL34260183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist