Organization
CHASTAINS INCORPORATED
Active
Other names
Owl Valley Medical Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MORGAN AUER RPH (SECRETARY)
(208) 750-1444
Entity
Organization
Contact information
Practice address
2315 8TH ST, LEWISTON, ID 83501-7301
(208) 750-1444
(208) 750-1022
Mailing address
2315 8TH ST, LEWISTON, ID 83501-7301
(208) 750-1444
(208) 750-1022
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1351CP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1351CP
BOP LICENSE
ID
05
—
805198500
—
ID
Enumeration date
01/16/2007
Last updated
08/22/2020
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