Healthcare Provider Details

I. General information

NPI: 1689912446
Provider Name (Legal Business Name): CHESTER PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2013
Last Update Date: 12/15/2021
Certification Date: 12/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MAIN STREET
CHESTER MT
59522
US

IV. Provider business mailing address

PO BOX 622 30 MAIN STREET
CHESTER MT
59522-0622
US

V. Phone/Fax

Practice location:
  • Phone: 406-759-5050
  • Fax: 406-759-5051
Mailing address:
  • Phone: 406-759-5050
  • Fax: 406-759-5051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KURT MATKIN
Title or Position: PHARMACIST/OWNER
Credential:
Phone: 406-759-5050