| NPI | 1427292341 |
|---|---|
| Doing Business As | COASTAL RX LLC |
| Entity Type | Organization |
| Authorized Contact | RHONDA WEISE Owner 904-621-8175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: FL PH23781) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2017-04-18 |