Organization · NPI-2
Coastal Pharmacy Services LLC
Pharmacy, Home Infusion Therapy Pharmacy · Hattiesburg, MS
NPI number1881150324
StatusActive
Last updated in NPPESMar 24, 2020
Details
- NPI
- 1881150324
- Entity type
- Organization (NPI-2)
- Legal business name
- Coastal Pharmacy Services LLC
- Organization subpart
- Yes
- Enumeration date
- Feb 20, 2019
- Certification date
- Mar 24, 2020
- Last updated
- Mar 24, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336H0001X | Pharmacy, Home Infusion Therapy Pharmacy | – | – | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 3336S0011X | Pharmacy, Specialty Pharmacy | – | – |
Other names
- Coastal Pharmacy Services (Doing Business As)
Practice location
3417 Hardy StHattiesburg, MS 39402-1502
Phone 601-910-7279 · Fax 601-300-8049
Mailing address
1922 Highway 22 W Ste AMadisonville, LA 70447-9490
Phone 985-792-9001
Authorized official
Hunter Farrar
Owner
9857929001
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