| NPI | 1588497028 |
|---|---|
| Doing Business As | COASTAL COMMUNITY PHARMACY #102 |
| Entity Type | Organization |
| Authorized Contact | KAVANAUGH CHANDLER CEO 912-275-8028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2024-08-21 |
| Last Update Date | 2025-01-29 |