Active NPI
Chastains Incorporated
Doing business as Owl Valley Medical Pharmacy
- Pharmacist
- Lewiston, ID
National Provider Identifier
1063563815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 1351CP
- Legal business name
- CHASTAINS INCORPORATED
- Doing business as
- Owl Valley Medical Pharmacy
- Practice address
- 2315 8TH St
Lewiston, ID 83501-7301 - Phone
- (208) 750-1444
- Fax
- (208) 750-1022
- NPI assigned
- Jan 16, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brian Morgan Auer, RPH
- Title
- Secretary
- Phone
- (208) 750-1444
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 1351CP | ID | Primary |
Addresses
Primary practice location
2315 8TH St
Lewiston, ID 83501-7301
Mailing address
2315 8TH St
Lewiston, ID 83501-7301
Phone (208) 750-1444
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1351CP | Other | ID | BOP LICENSE |
| 805198500 | Medicaid | ID |
Other names 1
- Owl Valley Medical Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Chastains Inc
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Owl Home Medical
- Durable Medical Equipment & Medical Supplies
- Lewiston, ID
- NPI 1851452049
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1063563815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2315 8TH ST",
"city": "LEWISTON",
"state": "ID",
"postal_code": "835017301",
"telephone_number": "208-750-1444",
"fax_number": "208-750-1022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2315 8TH ST",
"city": "LEWISTON",
"state": "ID",
"postal_code": "835017301",
"telephone_number": "208-750-1444",
"fax_number": "208-750-1022"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHASTAINS INCORPORATED",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-16",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "AUER",
"authorized_official_first_name": "BRIAN",
"authorized_official_middle_name": "MORGAN",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "208-750-1444",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "1351CP",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOP LICENSE",
"identifier": "1351CP",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "805198500",
"state": "ID"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Owl Valley Medical Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lewiston, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.