Coastal Medical, Inc.
NPI #1992847099 in Johnston, Rhode Island
Provider Information
- NPI Number
- 1992847099
- 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
- 1524 ATWOOD AVE
- Address 2
- STE. 340
- City
- Johnston
- State
- Rhode Island
- ZIP Code
- 02919-3228
- Phone
- (401) 949-0300
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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