Provider Demographics
NPI:1710396163
Name:CHAPMON, CHAI (RPH)
Entity Type:Individual
Prefix:
First Name:CHAI
Middle Name:
Last Name:CHAPMON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 S HAYNES AVE
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-4768
Mailing Address - Country:US
Mailing Address - Phone:406-234-4627
Mailing Address - Fax:406-232-0556
Practice Address - Street 1:519 S HAYNES AVE
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-4768
Practice Address - Country:US
Practice Address - Phone:406-234-4627
Practice Address - Fax:406-232-0556
Is Sole Proprietor?:No
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2795183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist