| NPI | 1477718385 |
|---|---|
| Doing Business As | COASTAL COMPOUNDING PHARMACY |
| Entity Type | Organization |
| Authorized Contact | AL DIXON Owner 912-756-3331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: GA PHRE009634) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2013-09-23 |