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General NPI Number Information
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NPI Number | 1790642288
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Entity Type | Individual
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Provider Name | CHARLES DEWAYNE CHAINEY RPH
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Gender | Male
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 1630 E PRIMROSE ST
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City | SPRINGFIELD
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State | MO
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Zip | 65804-7929
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Country | US
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Telephone | 417-885-4719
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Fax |
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Provider Business Mailing Address
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Address Line | 4686 S FARM ROAD 199
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City | ROGERSVILLE
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State | MO
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Zip | 65742-8696
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835G0303X
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Taxonomy Name | Geriatric Pharmacist
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License Number | 2000153193
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License Number State | MO
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