Organization Name:  CHASTAINS INCORPORATED


Practice Location:
720 16TH AVE SUITE 2 LEWISTON, ID 83501 US
Tel: 208-746-6755  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	3336L0003X	Suppliers Pharmacy Long Term Care Pharmacy	ID	883LS

Other Provider Identifiers:

Issuer	Number	State	Type
	002247900	ID	05
	6012967	WA	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin