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NPI Code Detail

MEDICARE: CHASTAINS INCORPORATED

MEDICARE: CHASTAINS INCORPORATED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail PharmacyPHAR.CF.00001133WA

Other Identifiers

General Provider Information

NPI Number : 1164573762
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHASTAINS INCORPORATED
Provider Business Mailing Address
First Line : 1275 HIGHLAND AVE
Second Line :
City : CLARKSTON
State : WA
Zip : 99403-2846
Country : US
Telephone Number : 509-758-5533
Fax Number : 509-751-9545
Provider Business Practice Location Address
First Line : 1275 HIGHLAND AVE
Second Line :
City : CLARKSTON
State : WA
Zip : 99403-2846
Country : US
Telephone Number : 509-758-5533
Fax Number : 509-751-9545
Authorized Official
Title or Position : SECRETARY
Name : BRIAN MORGAN AUER
Credential : RPH
Telephone Number : 509-758-5533
Provider Enumeration Date : 01/12/2007
Last Update Date : 09/11/2017

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Directions to “CHASTAINS INCORPORATED ” Practice Location

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