Coastal Medical, Inc.

NPI #1114069218 in Middletown, Rhode Island

Provider Information

NPI Number
1114069218
Entity Type
Organization
Organization Name
Coastal Medical, Inc.
Subpart
Yes (part of a larger organization)
Parent Organization
MEDVANTX,INC.
Primary Specialty
Non-Pharmacy Dispensing Site
Enumeration Date
Feb 13, 2007
Last Updated
Oct 17, 2012

Practice Location

Address
850 AQUIDNECK AVE
ZIP Code
02842-7244
Phone
(401) 846-0055

Authorized Official

Name
KENNY HEINE
Title
DIR. OF OPERATIONS
Phone
(858) 625-2990

Specialties & Taxonomy Codes

Specialty
Non-Pharmacy Dispensing Site

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