NPI | 1720128499 |
---|---|
Doing Business As | COASTAL MEDICAL - WAKEFIELD MEDICAL |
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 MD06582) |
Enumeration Date | 2007-02-08 |
Last Update Date | 2013-04-24 |