| NPI | 1700925898 |
|---|---|
| Former Legal Business Name | COASTAL DRUG STORE |
| Entity Type | Organization |
| Authorized Contact | THERESA LOU MINTZ President, Manager 910-754-6563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NC 09293) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2013-03-12 |