# COAST TO COAST MEDICAL, LLC

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

## Provider details

- **NPI number:** 1740214402
- **Authorized official:** LANCE MICHAEL HARRELL FNP (OWNER PROVIDER)
- **Authorized official phone:** (870) 732-0332

## Contact information

- **Practice address:** 710 N MISSOURI ST, WEST MEMPHIS, AR 72301-3150
- **Practice address phone:** (870) 732-0332
- **Practice address fax:** (870) 732-3078
- **Mailing address:** 710 N MISSOURI ST, WEST MEMPHIS, AR 72301-3150
- **Mailing address phone:** (870) 732-0332
- **Mailing address fax:** (870) 732-3078

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/10/2006
- **Last updated:** 05/22/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 205862762 | — | AR |
| 01 | — | 5C471 | AR BCBS GROUP \# | AR |