Provider Demographics
NPI:1205279825
Name:TCHIDA, DARREN LEE (PHARM D)
Entity type:Individual
Prefix:
First Name:DARREN
Middle Name:LEE
Last Name:TCHIDA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:569 32 RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-7053
Mailing Address - Country:US
Mailing Address - Phone:970-434-9651
Mailing Address - Fax:
Practice Address - Street 1:569 32 RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-7053
Practice Address - Country:US
Practice Address - Phone:970-434-9651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18477183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist