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Organization
COAST TO COAST MEDICAL, LLC
Active
Organization
COAST TO COAST MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE MICHAEL HARRELL FNP (OWNER PROVIDER)
(870) 732-0332
Entity
Organization
Contact information
Practice address
710 N MISSOURI ST, WEST MEMPHIS, AR 72301-3150
(870) 732-0332
(870) 732-3078
Mailing address
710 N MISSOURI ST, WEST MEMPHIS, AR 72301-3150
(870) 732-0332
(870) 732-3078
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205862762
—
AR
01
—
5C471
AR BCBS GROUP #
AR
Enumeration date
07/10/2006
Last updated
05/22/2026
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