Coastal Medical, Inc.
NPI #1720128499 in Wakefield, Rhode Island
Provider Information
- NPI Number
- 1720128499
- 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 8, 2007
- Last Updated
- Apr 24, 2013
Practice Location
- Address
- 70 KENYON AVE
- Address 2
- SUITE 321
- City
- Wakefield
- State
- Rhode Island
- ZIP Code
- 02879-4239
- Phone
- (401) 783-0084
Authorized Official
- Name
- MR. KENNY HEINE
- Title
- VP OF OPERATIONS
- Phone
- (858) 625-2990
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-Pharmacy Dispensing Site |
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