Provider Demographics
NPI:1881712404
Name:CHRONIC CARE INC
Entity type:Organization
Organization Name:CHRONIC CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP STRATEGY BUS DEV
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIPPENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-208-5402
Mailing Address - Street 1:18011 MITCHELL S
Mailing Address - Street 2:SUITE A
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6863
Mailing Address - Country:US
Mailing Address - Phone:844-295-4840
Mailing Address - Fax:844-295-4839
Practice Address - Street 1:300 N LONE HILL AVE
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-1741
Practice Address - Country:US
Practice Address - Phone:844-295-4840
Practice Address - Fax:844-295-4839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CA543553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2112329OtherPK