Provider Demographics
NPI:1780044172
Name:CHINCHUKS HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:CHINCHUKS HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:FIDELIA
Authorized Official - Middle Name:CHINWE
Authorized Official - Last Name:CHUKWUTO
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:614-599-8262
Mailing Address - Street 1:6710 CHRISTOPHER PARK LN
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-8510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6710 CHRISTOPHER PARK LN
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-8510
Practice Address - Country:US
Practice Address - Phone:614-599-8262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-144475-M-IV251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health