Leslie G Chastain

Individual provider Active NPI Pharmacist · Lawrenceburg, KY

NPI 1699375535 · NPPES record last updated Oct 29, 2020

Key facts

NPI
1699375535
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
017918 (KY)
Practice address
1000 Bypass N
Lawrenceburg, KY 40342-9462
Phone
(502) 839-1482
Fax
(502) 839-4268
NPI assigned
Oct 29, 2020
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
017918KYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East, LP Past
since Nov 1, 2020
Accepting new patients
Wal-Mart Stores East LP Past
since Nov 1, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 017918 KY Yes

Addresses

Primary practice location

1000 Bypass N
Lawrenceburg, KY 40342-9462

Mailing address

918 Milward Dr
Harrodsburg, KY 40330-8080
Phone (859) 338-8914

Other providers in Lawrenceburg, KY

All providers in Lawrenceburg, KY · Pharmacist in Kentucky

Sources for this page

Verify at the official NPI Registry.