| NPI | 1114124864 |
|---|---|
| Doing Business As | COASTAL MEDICAL - ELMHURST |
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Of Operations 858-625-2990 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: RI MD08852) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2013-10-24 |