# COASTAL COMMUNITY HEALTH SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Coastal Community Pharmacy \#102
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588497028
- **Authorized official:** KAVANAUGH CHANDLER MD (CEO)
- **Authorized official phone:** (912) 275-8028

## Contact information

- **Practice address:** 2321 POOLER PKWY STE 107, POOLER, GA 31322-4423
- **Practice address phone:** (912) 333-8255
- **Mailing address:** 100 PROFESSIONAL CENTER DR, BRUNSWICK, GA 31525-6743
- **Mailing address phone:** (912) 574-5075

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 08/21/2024
- **Last updated:** 01/29/2025