# COAST RX

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346100336
- **Authorized official:** RYAN BOUDREAU PHARMD (MANAGER)
- **Authorized official phone:** (504) 301-6638

## Contact information

- **Practice address:** 1105 BROAD AVE, GULFPORT, MS 39501-2415
- **Practice address phone:** (504) 301-6638
- **Mailing address:** 1105 BROAD AVE, GULFPORT, MS 39501-2415

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 11/13/2025
- **Last updated:** 11/13/2025