=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245381094
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHASTAINS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/16/2007
-----------------------------------------------------
Last Update Date | 01/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 720 16TH AVE STE 1
-----------------------------------------------------
City | LEWISTON
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83501-3768
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-743-5528
-----------------------------------------------------
Fax | 208-746-2785
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 720 16TH AVE STE 1
-----------------------------------------------------
City | LEWISTON
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83501-3768
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-743-5528
-----------------------------------------------------
Fax | 208-746-2785
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. BRIAN MORGAN AUER
-----------------------------------------------------
Credential | PHARMACIST
-----------------------------------------------------
Telephone | 208-743-5528
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 778RP
-----------------------------------------------------
License Number State | ID
-----------------------------------------------------